Indiana company quits Missouri Medicaid contract

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An Indiana company hired to assess the needs of thousands of Missouri Medicaid patients has quit after barely three months on the job following several complaints about its service and disagreements with state officials.

The CEO of SynCare LLC told The Associated Press on Thursday that the contract she viewed as a mission to help the disabled and elderly had become a public relations debacle — in part, because of the state's actions — and was no longer worth continuing.

State officials countered that SynCare had failed to live up to the contract — worth up to $5.5 million annually — to determine whether Medicaid recipients qualified for home-based health care and help with performing daily activities such as cooking, bathing and getting dressed.

The Missouri Department of Health and Senior Services said Thursday that it will immediately begin taking over the duties that were supposed to be performed by SynCare, which so far had been paid $1.3 million. The agency previously handled the state's caseload prior to hiring a private company.

The quick end to the contract marks a setback for Missouri, which hired SynCare under a 2010 state law that had been intended to save the state money and avoid potential conflicts of interest in which home-care providers also conducted the assessments of the amount of care clients needed. SynCare, based in Indianapolis, was selected to make independent determinations about the in-home care needs of patients.

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. During the ensuing months, complaints also were raised by delays in receiving service.

Patients and advocates held news conferences around the state Tuesday alleging that SynCare staffers were unprepared, overwhelmed and poorly trained. On Wednesday, members of a Missouri House committee grilled state health department officials about the contract with SynCare.

SynCare CEO Stephanie DeKemper told the AP that she had discussions late into Wednesday night with state health department officials about potential contract changes. But ultimately, DeKemper sent the agency a letter withdrawing from the contract, and the department responded with a 10:20 p.m. Wednesday email acknowledging company's decision.

"This was as much a mission for us as it was a contract to deliver services. We really had a heart for the participants," DeKemper said Thursday. But "we came into an environment that was controlled by providers and a contract that, was obvious to us, was not going to be given an opportunity to work itself out through normal processes."

Health Department Director Margaret Donnelly issued only a brief statement Thursday that did not explain how the contract ended but noted that department personnel would begin the transition of performing SynCare's duties.

"It is clear that the company is not able to meet the terms and conditions of their contract," Donnelly said. "The department remains committed to ensuring that Missourians receive the services they need in a timely and efficient."

State Rep. Ryan Silvey, R-Kansas City, claimed the contract was ended as a direct response to the tense hearing held Wednesday by a budget transparency committee for which he is chairman.

"This has been a disaster since day one and I will be demanding that the department take any measures necessary to make the Missouri taxpayer whole," said Silvey, adding that he hoped the state would quickly find another contractor.

State Rep. Tom Flanigan, R-Carthage, who is chairman of a House committee that handles the health department budget, said Thursday that "it became increasingly evident that this contract needed to be terminated."

DeKemper said it was unfair to pin the problems solely on her company. She said that when the contract began, state officials advised the company 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 got repeatedly overwhelmed, she said the department only belatedly agreed to allow a change in the company's staffing levels.

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, and not enough time had passed since then evaluate the success of the changes, DeKemper said.

In its first 75 days, SynCare handled over 73,000 telephone calls and conducted more than 11,000 in-home-care assessments, 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 is a certified minority enterprise that helps evaluate and coach Medicaid patients at high risk for hospitalization—those with multiple chronic diseases or high-risk pregnancies, for example.

Last June, SynCare withdrew a request for a property tax abatement from the Indianapolis Metropolitan Development Commission tied to the creation of 114 jobs, citing "changing market conditions." At the time, the firm had 31 employees.

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