Indianapolis-based SynCare LLC has been touting its growth in Missouri since it entered the market in 2009. But now SynCare’s excursions in the show-me state have turned into a nightmare.

Less than four months after SynCare began a $5.5 million contract to determine whether Medicaid patients were eligible for home-based care, the company was forced to withdraw from the contract after a public outcry by patients and patient advocates.

SynCare uses nurses and social workers to call and visit Medicaid patients to evaluate their needs and teach them how to handle their health issues, in order to avoid expensive hospitalizations. The goal in Missouri was also to help the state Medicaid plan save money by getting an upfront determination of how much care patients need.

But on its first day of work in mid-May, SynCare's customer call center was overwhelmed by about 1,000 telephone calls, resulting in unusually long waits for patients and care providers dialing in, the Associated Press reported. Since then, there have been many complaints about delays in receiving service.

"This has been a disaster since day one and I will be demanding that the [health] department take any measures necessary to make the Missouri taxpayer whole," said State Rep. Ryan Silvey, R-Kansas City, according to the Associated Press. SynCare so far has been paid $1.3 million.

Patients and advocates held news conferences around the state on Aug, 30 alleging SynCare staffers were unprepared, overwhelmed and poorly trained.

SynCare CEO Stephanie DeKemper said when the contract began, state officials told SynCare it would need 20 people in a call center and 110 employees in the field to perform care assessments for patients. After the call center was repeatedly overwhelmed, state officials were slow to allow a change in the company's staffing levels, she said.

It was only recently that the call center had been built up to 60 employees and the field assessment staff had been reduced to 57 people, DeKemper said.

"We were implementing the contract," she said, while acknowledging there were some glitches. But "it was handled publicly very wrong [by the state] and it wasn't given an opportunity to work itself out."

SynCare proudly announced its winning of the Missouri contract in February, and still has the press release prominently displayed on its website. SynCare said at the time it would hire 157 people in Missouri, making it by far its largest site of operations, and would boost its Indianapolis employment from about 30 to about 40.

SynCare still serves Medicaid patients in Indiana, Missouri and Nebraska through contracts with health insurance companies.

SynCare has been growing since DeKemper purchased the company in January 2009. She previously helped found the Indiana Minority Health Coalition and served as its first executive director. She later became chief operating officer of Managed Health Services, a subsidiary of St. Louis-based Centene Corp., which operates Medicaid managed care plans for state governments.