UPDATE: Indiana company quits Missouri Medicaid contract

Thursday, September 1, 2011 | 7:54 p.m. CDT; updated 8:41 a.m. CDT, Friday, September 2, 2011

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

Stephanie DeKemper, CEO of SynCare LLC, said 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 quit because it was about to be fired and had failed to live up to a 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 about 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.

DeKemper said she had discussions late into Wednesday night with state Health Department officials about potential contract changes. Ultimately, DeKemper sent the agency a letter withdrawing from the contract, and the department responded with an email at 10:20 p.m. Wednesday acknowledging the 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 said Thursday that the agency had been preparing to fire SynCare.

"SynCare sent us the letter knowing that we would be terminating the contract," Donnelly said. She declined to elaborate on the specific reasons why the state would have cut ties with SynCare but said in a written statement released earlier Thursday that the company "is not able to meet the terms and conditions of their contract."

"We're working as quickly as we can to get people the services they need and to transition SynCare out of the contract," Donnelly said.

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 to evaluate the success of the changes, DeKemper said.

Donnelly declined to comment on DeKemper's assertions about the state's staffing guidance.

In its first 75 days, SynCare handled more than 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."

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Harold Sutton September 1, 2011 | 9:00 p.m.

Why did this contract provider need to be from out of state?
How does sending money out of state save money?

(Report Comment)
John Bohnarczyk September 2, 2011 | 8:56 a.m.

Well, sure. If I was one of the home health care providers I would want Syncare out of the picture, too. I would only begin to imagine the fraud and abuse by the Providers; allowing services that were not needed to line their own pockets with taxpayers money. Syncare, since its start in May, has probably saved the State of Missouri tens of thousands of dollars by cutting services to those who are very capable of taking care of themselves. It seems that those that are complaining the most are the ones who have the Providers interests in mind. The State should have a third party assessing the needs of the people. It would just keep it all above board and honest. But hey, that's just the way I see it.

(Report Comment)
Sally Willis September 2, 2011 | 9:22 a.m.

-State officials countered that SynCare quit because it was about to be fired and had failed to live up to a contract
SynCare was having a problem from the beginning they had just hired several new employees two months ago worked them into the ground then one month later laid them off, Several of these people from Columbia. I agree with John Bohnarczyk that we do need an outside source to do this job but not necessarily from another state... Hey let's stop and think for a minute what a great way to create Missouri jobs, and keep our taxpayer dollars in our state!

-Patients and advocates held news conferences around the state Tuesday alleging that SynCare staffers were unprepared, overwhelmed and poorly trained. Of course they were those employees were hired given a two week crash course in St. Louis and then thrown to the sharks and ran into the ground! I truly feel for all involved. I think SynCare made a bad situation worse, took our money and ran.

(Report Comment)
Jeremy Calton September 2, 2011 | 4:30 p.m.

"a great way to create Missouri jobs"

For $5.5 million simply to create a few jobs, I certainly wouldn't use the word "great."

(Report Comment)

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