Health / Medicaid / SynCare
11:36 am
Thu September 1, 2011

Mo. Dept. of Health and Senior Services to take over SynCare role

Updated 4:25 p.m. with comments from Mo. House Budget Chairman Ryan Silvey (R, Kansas City), who also oversees an interim committee looking into complaints against SynCare.

The State of Missouri is taking over the duties of SynCare, an Indianapolis-based company which won a contract in February worth as much as $5.5 million a year to determine whether thousands of Missouri Medicaid recipients qualify for home-based medical services or help with daily chores. 

Numerous complaints came to light Wednesday during a House committee meeting about the services provided by the company.  They include patients being put on hold for several hours on the phone, and case evaluations that should have taken less than three weeks to complete taking three months instead.  House Budget Chair Ryan Silvey (R, Kansas City) says inadequate staffing levels also led the state to loan 33 employees to SynCare to handle the heavy case load.

“There were clauses in the contract that required certain staffing levels, which, as you can imagine, would probably help with the wait times if they were meeting (the) staffing levels that they were required to, but they weren’t even doing that," Silvey said.

According to the Associated Press, the company has received $1.3 million since the contract took effect in mid-May, quickly followed by a litany of concerns, from inordinately long telephone wait times to sharp reductions in the number of hours of allowable care. Others have described being ignored entirely.

In an Associated Press report yesterday, SynCare CEO Stephane DeKemper acknowledged that the company has fallen short of its standards, but said the state also shares some responsibility because it grossly underestimated the amount of work the company would be doing.

The report focused on the fact that SynCare would be getting help from the state, but today, it appears that Missouri's Department of Health and Senior Services will be taking over entirely.

Here's a statement from the Department's director Margaret Donnelly on the situation:

"Effective immediately, the Department of Health and Senior Services will begin to transition the duties previously performed by SynCare to DHSS. It is clear that the company is not able to meet the terms and conditions of their contract. The Department remains committed to ensuring that Missourians receive the services they need in a timely and efficient manner."

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."

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."