Statement of David Jordan, President and CEO of the United Methodist Health Ministry Fund, on Governor Kelly’s 2024 Medicaid Expansion Proposal:
Expanding Medicaid will bring down health care costs for all Kansans. Most importantly, it will provide health coverage to 150,000 Kansans who earn too much to qualify for Medicaid but too little get subsidized coverage on the health care marketplace. Expanding Medicaid will protect Kansas hospitals, create jobs, and strengthen our communities. We applaud Governor Kelly for her continued commitment and tireless work to expand Medicaid. Failure to expand Medicaid has resulted in Kansas losing nearly $7 billion. It’s time to expand Medicaid. As Governor Kelly’s “Healthy Workers, Healthy Economy” tour highlighted, with the critical need for Medicaid expansion in every corner of the state, we can’t afford to wait another year.
While we share the Governor’s support for Medicaid expansion and support the bipartisan effort to ensure that 2024 is the year for Kansas to expand Medicaid, we oppose the proposed work requirements included in the plan. Implementing work requirements creates barriers to coverage and hoops for Kansans to jump through to get health coverage they qualify for as part of expansion. No Kansan should need to jump through unnecessary hoops to access health care. We should be breaking down barriers to care instead of implementing policies that result in the loss of health coverage.”
Tag: Access to Care
Statement on 2024 KanCare Expansion Proposal
Telehealth in Kansas: Provider and Patient Experience During COVID-19 Cross-Study Report
The results of four phases of telehealth research during the COVID-19 pandemic are clear. Patients, providers, and administrators expressed that telehealth increased access to care and saw benefits beyond expanding access during the pandemic.
The United Methodist Health Ministry Fund and REACH Healthcare Foundation commissioned research on telehealth in Kansas to understand its use by consumers and providers, and to gain their perspectives on areas for improvement. The research included a statewide survey of providers, a statewide voter poll, health provider interviews and consumer focus groups.
Read the telehealth cross-study report.
Key takeaways include:
- While providers were attuned to access and continuity of care, patients were attuned to benefits like convenience, savings of time and money, and the importance of choice between telehealth and in-person services.
- Overall, patients and providers were satisfied with telehealth, though some reported specific bad experiences. Providers and patients agreed not all health services were suitable for telehealth and believed they knew when it was time for an in-person visit.
- Patient access to devices and internet connectivity was generally good; the same was true for providers. Patients, particularly those who participated in the consumer poll, wanted rural broadband access to be increased to improve access to telehealth and improve health.
Learn more about the results in the full report or research brief.
Webinar slides
Telehealth Resources
All telehealth materials can be found on our Kansas Telehealth page.
- Consumer focus group report and research brief.
- Provider interview full report and research brief
- Statewide voter poll report and by the numbers
- Fall 2020 provider survey report and policy brief
- Kansas Hospital Association podcast episode: Telehealth’s Current and Future Role in Patient Care
- Forward Focus podcast episode: What we advocate for: Telehealth and digital equity
Consumer Focus Groups Find Kansans Want Telehealth to Stay
New consumer focus group research with Kansas patients demonstrates that telehealth has increased access to care, has room for improvement, and that patients want telehealth to be a permanent option. This research reinforces results from a 2021 consumer poll of Kansas voters—participants had positive experiences with telehealth, found it to be an important option, and wanted policymakers to support telehealth by increasing access, including broadband capabilities.
View the consumer focus group report
The consumer focus group qualitative research, conducted for the Health Fund and REACH Healthcare Foundation by the University of Kansas Medical Center during 2021 and 2022, included an oversampling of Black, Hispanic, Spanish-speaking and rural consumers to ensure sufficient sample sizes of minority populations.
Summary of Patients’ Perspectives
A summary of the patients’ perspectives on telehealth includes:
- Many participants were enthusiastic about continuing to use telehealth—finding it easier, more convenient, safer and a time saver.
- Potential cost savings related to spending less on gas and transportation and saving time, including missing less work, crossed socioeconomic backgrounds, genders, and parental or caregiver status.
- Most suggestions for improvement focused on making telehealth a more integrated part of health care through better care coordination and greater standardization of scheduling, processes, and platforms. Patients wanted to see certainty in terms of costs and payor policies. They also recognized the need for better broadband internet access.
- Telehealth allowed some patients to receive care that was many hours away or that they otherwise would not have been able to access.
- Some participants did not have access to reliable transportation or to transportation at all.
- Patients did not like that it was harder to show providers injuries or other visible health conditions on a telehealth videoconference.
- Most participants reported using their smartphones for telehealth videoconferencing. Many also used laptops, and a few used iPads or other tablets.
- Several participants noted specific barriers to utilizing telehealth regarding interpretation services, insurance coverage, and tech savviness.
- Overall, caregivers of elderly parents and children alike found telehealth to be a convenient option that aided in better use of their time and generally lowered the burden of caregiving.
Kansans want telehealth to remain an option for care. An initial provider survey, a statewide poll of voters, also co-funded by the Health Fund and REACH Healthcare Foundation, in-depth provider interviews, and this consumer focus group research are evidence that telehealth can play a significant role in improving health care access for Kansans.
This was the fourth phase of telehealth research. Join us on Wednesday, September 28 at noon as we present the cross-study results during the Telehealth in Kansas: Provider and Patient Experience During COVID-19 live webinar.
Telehealth Resources
All telehealth materials can be found on our Kansas Telehealth page.
- Consumer focus group report and research brief.
- Provider interview full report and research brief
- Statewide voter poll report and by the numbers
- Fall 2020 provider survey report and policy brief
- Kansas Hospital Association podcast episode: Telehealth’s Current and Future Role in Patient Care
- Forward Focus podcast episode: What we advocate for: Telehealth and digital equity
Webinar: Navigating Vaccine Hesitancy with Families
Childhood vaccination is a sensitive topic. Whether you’re discussing wellness vaccines or COVID-19 vaccines, it’s important to meet people with empathy and active listening. This webinar on navigating vaccine hesitancy with families was recorded on Tuesday, April 26, 2022.
Speakers included Dr. Gretchen Homan, president-elect for the Kansas Chapter of the American Academy of Pediatrics and former Immunize Kansas Coalition chair; Erica McGinley, nurse consultant for Child Care Aware of Kansas; and David Jordan, president and CEO of the United Methodist Health Ministry Fund.
Navigating Vaccine Hesitancy with Families webinar slides
Health Fund resources specific to COVID-19 vaccines
- Faith in Vaccines – sermon guide and toolkit
- Faith in Vaccines Lay Toolkit
Black maternal health crisis conversation
Among industrialized countries, the United States has the highest maternal mortality rate. In Kansas, the maternal mortality rate is 14.8—meaning 14.8 women die for every 100,000 live births. Black women are more likely to die than white or Hispanic women.
Dr. Sharla Smith of the Kansas Birth Equity Network joined Health Fund CEO David Jordan for a conversation on the Black maternal health crisis.
“Black women are two to three times more likely to die of childbirth-related issues than white women,” said Dr. Smith. “We’re seeing that crisis happen in the absence of the social determinants of health. So, Black women from the wealthiest communities still have worse outcomes. Black educated women still have worse outcomes than all other women.”
Expanding KanCare would strengthen rural health care, rural communities
This commentary by Health Fund President David Jordan on strengthening rural health care through KanCare expansion originally appeared in the Wichita Eagle on March 9, 2022.
Kansas is a rural state with nearly one-third of the population living in rural communities. As Kansans we take pride in self-reliance and taking care of our own.
Yet Kansans living in rural and frontier areas are more likely to be uninsured than those in more populated communities. Kansans living in frontier communities have the highest uninsured rate in the state (12.9%). When it comes to health care and sustaining rural health systems and communities, we need more than self-reliance. We need health insurance.
Many of our uninsured neighbors are hardworking Kansans who earn too much to qualify for KanCare, the state’s Medicaid program, and too little to qualify for health insurance through the Affordable Care Act. In fact, a single parent of two kids earning more than $4.00 an hour earns too much to qualify for KanCare.
These hardworking Kansans are our neighbors. Kansans like Jim, an uninsured farmer who enjoys working with crops and large machinery. He lost his health insurance after a seasonal job ended. Getting insurance now is beyond his means.
He’s dealing with diabetes and an injured foot. The bones were broken, but Jim hasn’t been able to get it addressed. He calls it a “Catch-22.” He was hurt and needs money to get well, but he can’t work to make money because of the injury.
Without health insurance, Jim is scraping by and going without regular care.
Emergency room care is often the only option for uninsured Kansans like Jim. But hospital bottom lines and viability are threatened if uninsured patients can’t pay bills. Currently, 70 rural Kansas hospitals are financially vulnerable and categorized as at-risk of closing, more than in any other state.
Rural and frontier towns rely on hospitals for health care and to anchor communities.
According to the Kansas Hospital Association, in 2020, 12% of Kansas employment was in the health services sector. The health care sector was the fifth largest producer of total income and of total sales.
For health and prosperity, a sustainable health system is crucial to the future of our rural regions and our rural way of life.
Kansas can take an immediate step to strengthen rural health systems and communities by expanding KanCare, the state’s Medicaid program.
Multiple studies show that hospitals, particularly rural ones, are at significantly higher risk of closure in states that have not expanded Medicaid. A 2018 study published in Health Affairs found “Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of uninsured adults before Medicaid expansion.”
Expanding KanCare would cut our uninsured rate in half. Expansion would boost hospital finances by covering 25% of the uncompensated care in rural hospitals and 44% in frontier hospitals.
Kansans know expanding KanCare is the right thing to do. Expansion has broad support across geography and political party. A new survey finds almost 8 in 10 Kansas voters (78%) support expanding KanCare.
All neighboring states have expanded their Medicaid programs. Expanding KanCare would keep us competitive — adding nearly 23,000 new jobs to the state’s economy and increasing economic output by $17 billion.
Expanding KanCare would strengthen rural health care and help ensure rural Kansans get the health care they need while improving their economies. The time to expand is now.
Medicaid expansion would help all Kansans
The following is an opinion piece by Health Fund President David Jordan.
Eight years of inaction by policymakers have resulted in Kansans paying more for health care, our communities’ ability to deliver health care being pushed to the brink, and billions of dollars in lost economic opportunity.
Today, the Kansas legislature begins its annual legislative session, providing yet another opportunity to expand KanCare, Kansas’ Medicaid program. Kansas is one of only 12 states that has not expanded Medicaid, to the detriment of the 165,000 hardworking Kansans who fall in the coverage gap.
Who’s in the coverage gap?
A Kansas family of three with an annual income of $8,345 makes too much to be covered by KanCare, and too little to receive Affordable Care Act (ACA) marketplace subsidies. In this case, a single mother with two kids who works a minimum wage job 23 hours per week falls into the coverage gap – earning too much to qualify for KanCare and too little to qualify for health coverage through the ACA.
According to the Alliance for a Healthy Kansas, more than two-thirds of adults eligible for insurance through Medicaid expansion work or are in working families, and most are employed in industries less likely to offer affordable health insurance, such as service, construction, and retail.
At a time when all Kansans are experiencing the pinch of increased costs to provide for our families, health care is no exception. Expanding KanCare would not just benefit those in the coverage gap, it would also help bring down the costs of health care for Kansans and reduce costs for businesses.
As policymakers return to Topeka, it is important to remind them that expanding KanCare is a budget-neutral Kansas-specific policy that would help 165,000 hardworking Kansans who fall in the coverage gap access health care and reduce their risk of medical debt and bankruptcy.
Beyond improving health and economic security, expanding KanCare would add nearly 23,000 good-paying jobs to our state, increasing our economic output over the next three years by $17 billion and the personal income of Kansans by $6.3 billion. Expansion would also help protect access to care for our rural neighbors; 76 hospitals in Kansas are currently at risk of closing. Expanding KanCare would help rural Kansans access the care they need while boosting their local economies.
Join the conversation
To learn more about the state of KanCare and its potential expansion, you can attend a virtual lunch on January 13 with key leaders within the health sector to discuss the path forward for Medicaid expansion in Kansas.
Kansas Lt. Gov. David Toland, who also serves as the Kansas State Secretary of Commerce, will provide an update on the Governor’s plans around KanCare expansion and will share current data on the economic impact expansion will have in Kansas.
Sen. Doll, a Republican legislator from Garden City and longtime advocate of KanCare expansion, will discuss the path forward for expansion through the legislative process and how health leaders can help leverage their voices and positions to support this work.
Expanding KanCare is critically important to improving health, reducing costs for Kansas families, and creating jobs. To achieve this goal, we all need to engage in the discussion and let our policymakers know that we can’t afford to wait another year to expand KanCare.
Expanding Postpartum Medicaid Coverage Will Improve Outcomes
Testimony presented by Health Fund President David Jordan to the KanCare Oversight Committee on Thursday, September 23, 2021.
Chair Hilderbrand, Vice Chair Landwehr, and Members of the Committee:
Thank you for the opportunity to provide public comment regarding maternal and child health issues in Kansas. I want to focus on the importance of extending postpartum coverage for new mothers enrolled in KanCare.
The United Methodist Health Ministry Fund (Health Fund) is a 35-year-old, $70 million health philanthropy located in Hutchinson. Our mission is to improve the health of Kansans. We focus on three strategic areas – access to care, early childhood development, and Healthy Congregations, a program aimed at addressing community health by engaging churches throughout Kansas. Over the last three decades we have provided more than $75 million in funding to improve the health of Kansans.
We support and invest in early childhood initiatives because research shows investing early creates the best health outcomes and the greatest return on investment.
One maternal and child health issue that has emerged during the pandemic that ties together our interests and investments is extending postpartum coverage for Kansas mothers enrolled in KanCare.
In 2018, Medicaid covered 39% of the 36,268 births in Kansas – 14,145 newborns. Prior to the public health emergency resulting from the COVID-19 pandemic, the majority of new mothers enrolled in KanCare would have lost their coverage 60 days after giving birth.
As a result of the ongoing public health emergency, Kansas cannot discontinue coverage for new mothers after 60 days. Kansas, like other states, has seen the benefits of this temporary policy change. Extending Medicaid coverage postpartum to 12 months enabled mothers to access critical health care and mental health services, ensuring mothers and babies have the healthiest start to life.
Recent federal policy change creates the opportunity for Kansas to extend coverage. Already, other states like Indiana and Tennessee are taking advantage of this opportunity.
Healthy mothers are important to building healthy families, which is why we need to act before the public health emergency ends. Otherwise, new mothers may lose their current health coverage to the detriment of their health, their children’s health, and long-term family stability.
Coverage Ends Too Soon: Maternal Mortality and New Mothers
Before the pandemic, pregnant Kansans were eligible for Medicaid coverage through the duration of their pregnancy and 60 days postpartum if their household income was at 171% or less of the federal poverty level. Although their newborn remained covered by Medicaid through their first year of life, the postpartum mother lost coverage on day 61 unless her household income was at 38% or less of the federal poverty level (FPL). A married woman with a single child would lose coverage on day 61 if her combined household income was above $8,345.
Before coverage was extended during the pandemic, each year in Kansas approximately 9,000 postpartum mothers lost Medicaid coverage 60 days after the end of pregnancy.
The Kansas Maternal Mortality Review Committee found that between 2016 and 2018 nearly one-quarter of all Kansas pregnancy-related deaths occurred between 43 days and one year postpartum. Nearly half of all pregnancy-associated deaths occurred in the same period.
According to a Kansas Department of Health and Environment (KDHE) Impact paper on postpartum coverage, “Findings from 2016-2018 cases revealed that women covered by Medicaid during pregnancy and delivery were more than three times as likely to die within one year of pregnancy when compared to women covered by private insurance. Among non-Hispanic Black women in Kansas, a greater proportion of pregnancy-associated deaths occurred during pregnancy (62.5%). Extending postpartum Medicaid coverage to 12 months creates opportunities to improve access to quality health care for high-risk populations, before, during, after and between pregnancies, potentially reducing pregnancy-associated deaths and closing the disparity gap . With many of the pregnancy-associated deaths involving health care and occurring months after delivery, these data suggest that a Medicaid postpartum coverage extension will help more women access care necessary to address critical, potentially fatal health concerns. National data published in February 2019 by the American Journal of Managed Care (AJMC) reveals that extending Medicaid coverage to 12 months postpartum is associated with 1.6 fewer maternal deaths per 100,000 women compared to rates for states that only provide coverage for the required 60-day time period.”
Having coverage and access to routine and preventive health care can help prevent these deaths that occur largely after coverage ends. Ending Medicaid eligibility for postpartum mothers after 60 days is too soon. We urge the state to take action to extend access to health care for Kansas mothers to prevent deaths and to reduce disparities.
Expanding Postpartum Coverage to 12 months Will Improve Health Outcomes in Kansas
The emergency extension of postpartum coverage during the pandemic has affirmed the value of extending a mother’s coverage. Mothers have been able to access critical health and behavioral health services.
Extending Medicaid coverage for a continuous 12 months postpartum can improve health outcomes for mothers, children, and families across the state. It is important to note that a child’s health is tied closely to their parent’s health and access to health care. Parental enrollment in Medicaid is associated with a 29% higher probability that a child will receive an annual well-child visit. Therefore, it is important for the health of the mother and child during the critical twelve-month period postpartum that both mother and child can access health care.
Nearly 20% of Kansas women below 200% of the federal poverty level experienced postpartum depression in the year after giving birth. It is vital that mothers have access to mental health and substance use services during this period because the postpartum period is a time when mothers are particularly susceptible to substance use relapse. Recognizing that according to KDHE, between state fiscal years 2012 and 2017, parental substance use was the primary reason that 70% of children under the age of one entered foster care, extending coverage to enable mothers to get substance use services can prevent interaction with the child welfare system.
Beyond improving health outcomes new mothers and children, extended postpartum coverage is also predicted to lead to a decrease in long-term Medicaid costs through the provision of early medical interventions and coordinated care, preventing postpartum complications and worsening chronic conditions due to a delay in early identification and intervention.