State cancels SynCare contract

On Sept. 1, the state terminated its $5.5 million contract with Indianapolis-based SynCare LLC, which has come under criticism for its handling of the state’s in-home Medicaid clients.

The move comes just three months after legislators gave assessment responsibilities to SynCare. The company became the third-party assessor for the Missouri Department of Health and Senior Services on May 19.

At a Sept. 1 news conference held by home health care provider Oxford HealthCare to convey its problems with SynCare, Sen. Jay Wasson, R-Nixa, received a phone call from his Jefferson City office that the contract had been nullified.

“There have been so many complaints and so many problems – it was obvious to me that SynCare was simply not prepared to handle the bulk of this work,” Wasson said. “The assessments weren’t getting done, and once the assessments were done, the services were not being delivered in a timely fashion. There were some real communication problems. I don’t know if they just didn’t have enough people – I just don’t know.”

He said in his talks with DHSS, the department wanted to give the company enough time to “ramp up” its work force and address the issues. Wasson said he appreciates that the state was trying to save money by hiring SynCare and keeping providers from doing the original face-to-face assessments with patients, but a change had to be made because the company was simply not living up to its obligations.

Calls to SynCare President and CEO Stephanie DeKemper were not returned by press time. The St. Louis Post-Dispatch reported that SynCare recently laid off 29 workers in its Ballwin office, which services Missouri clients.

DHSS Director Margaret Donnelly released the following statement Sept. 1 with regard to the move: “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 its contract. The department remains committed to ensuring that Missourians receive the services they need in a timely and efficient manner.”

Wasson said DHSS would handle all Medicaid assessment services in the interim until a more permanent plan is put in place.

On Aug. 30, Missouri home care advocates held news conferences in four cities to call on legislators to remove SynCare as the organization that determines whether some 53,000 Medicaid recipients can receive health care in the home for services such as bathing, meal preparation and house cleaning.

In Springfield, the Southwest Center for Independent Living hosted one of the conferences.

Shelby Butler, access coordinator for SCIL, said SynCare has consistently not met its obligations to its clients who are seeking access to care in the home or changes in their Medicaid services.

“There are many people out there who are in need of home and community-based services,” Butler said. “Many of them have had to wait long periods of time and a lot of that is while people are at risk of going into a nursing home. And many people are sitting in nursing homes waiting to get out.”

With delays in changes to care, the fear was that many Medicaid recipients would become hospitalized or have to move into nursing homes to have their needs met – a less desirable and more expensive proposition.

Cheryl Fitch, vice president of Springfield-based Oxford HealthCare and vice president of the Missouri Alliance for Home Care, said her company has worked with a variety of organizations that have acted as the assessors of eligibility for in-home services. The situation with SynCare, Fitch said, was untenable.

“From the get-go, there has been no communication. We were told to call them with any concerns or problems or when we wanted to talk about a patient’s assessment or new patients, whatever, and everybody across the state has done that. Everybody has reported that there have been hour waits, three-hour waits, just trying to get one patient on,” Fitch said. “Our patients have also tried to talk with the SynCare company, and they’ve also been asked to wait an hour or two hours. And when you’re talking about the average age of a patient being 83, they can’t stay on the phone that long. They have health issues.”

SynCare was required to make contact with applicants within three days and in-home evaluations within 15 days. Patients often were waiting weeks or months to learn about the status of their applications, Fitch said. In early June, she said Oxford had a backlog of 30 requests for care, and by the end of August, the requests had risen to roughly 170.

“This is about taking care of the patients we’re supposed to be helping,” said State Sen. Bob Dixon, R-Springfield, a vocal critic of SynCare, who wants DHSS to reconsider the merits of a third-party assessment firm. “We’ve got to deliver the services we have said we’re going to deliver.”[[In-content Ad]]