Four awarded Medicaid contracts; Humana Health didn't make the cut - Kansas City Business Journal:

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Seven companies initially bid for a piece ofthe state'sw Medicaid business in the seveh counties surrounding Kansas City, although a Florida HealthCare USA, withdrew from the competition a week beford the award. A spokesman for the company citedthe firm'sd desire to focus on rapid growth in otherr parts of Missouri. The four Kansaws City area winners will offer capitate d managed care services toabout 87,000 Medicaird enrollees in a move designexd to arrest skyrocketing programk costs.
Those chosen were Family Health Partners, an HMO partnershi p of Children's Mercy Hospital and Trumahn Medical Center; FirstGuard Health Plan, an HMO affiliatec with Swope ParkwayHealth Center; the area's largest preferred provider organization; and TriSource HealthCare a Blue Cross subsidiary. Vendors not selectefd were Humana Health Plans of Missourui and Kansasand Miami-based Americanh Medical Plans of Missouri. Humana'w defeat caught many off guard.
"Everybody's been surprise that Humana did not get an saidGail Shafton, president of Overlanrd Park-based Cue Resources, a health care consulting "Their experience on the east side of the stats didn't seem to matter much when they bid Humana last year was one of seven successful bidders for Medicaid managed care contracts in St. The company now has about 13,000 enrolleesw in the St. Louis area. Shafton noted that Humana has long had an extensiv e urgent careand after-hours care infrastructure in the Kansas City area. Network capability was one of the contract'sd central criteria, she said. "It woulxd have appeared that they hadan edge," Shafton said.
Ron Fugate, a Humanaq spokesman, said the company was "surprised and that it didn't get a contract. "But we certainly wish those who did the best of luck in servinbg theMedicaid population," he said. Fugat noted that Humana has been servingfapproximately 1,700 Jackson County Medicaid enrollees for the past year as part of the county'a managed care demonstration prototype program. "Those individuals who chose Humanq are going to have to choose different doctors for their health care," he said.
Asked why Humana mighg have lost out, despite its involvementf in thedemonstration model, Fugate said he "didn't have a "When we see how the bids were rated, we migh have a better understanding." Donna Checkett, director of the Division of Medicak Services in the state's Department of Social Services, said the bids were evaluatecd and ranked by an independent group under the auspicesz of the state's Office of Administration. Those rankingsd put TriSource first, HealthNet and Family Health Partnerse tiedfor second, FirstGuard third and Humanw fourth, Checkett said.
"It was critical that the bidderds demonstrate in the written component their plan for educational and outreach and prevention she said.