Kansas Medicaid is administered by the Kansas Department of Health and Environment (KDHE), Division of Health Care Finance. The program runs through KanCare, an aggressive, full-risk managed care model that covers nearly the entire Medicaid population: physical health, behavioral health, and long-term services and supports, including nursing facility care and home- and community-based services, are all folded into a single capitated contract with each managed care organization. KanCare operates under two federal authorities, an ongoing Section 1115 demonstration and a Section 1915(b) waiver, both currently authorized through December 31, 2028. Kansas's current KanCare MCO roster is Healthy Blue, Sunflower State Health Plan, and UnitedHealthcare Community Plan of Kansas, under contracts running through December 31, 2027.
KanCare enrolls nearly all Kansas Medicaid beneficiaries in one of three managed care organizations, each under an identical capitated contract covering physical health, behavioral health, and long-term services and supports. The current three-MCO roster is Healthy Blue, Sunflower State Health Plan, and UnitedHealthcare Community Plan of Kansas, under contracts running through December 31, 2027. CMS's own 2024 enrollment data, the most recent year on file, still reports the prior roster under this same contract structure: Aetna Better Health of Kansas (112,495 members, 14,460 dual-eligible), Sunflower State Health Plan (118,053, 13,056 dual-eligible), and UnitedHealthcare Community Plan of Kansas (127,984, 16,510 dual-eligible), a snapshot from before the 2025 MCO transition rather than the current roster. Kansas also runs three small PACE organizations outside KanCare: Bluestem PACE, Midland Care, and Via Christi (an Ascension affiliate), together covering just over 1,000 members statewide in 2024.
Long-term services and supports, including nursing facility care and home- and community-based services, are capitated directly into the same KanCare MCO contract that covers physical and behavioral health; there is no separate LTSS carve-out or case-management entity standing between a member and their MCO. Underneath that integrated delivery structure, Kansas still maintains eight separate Section 1915(c) HCBS waivers as their own federal authorities, each serving a distinct population: Intellectual and Developmental Disabilities, Frail Elderly, Physical Disability, Serious Emotional Disturbance, Technology Assisted, Autism, Brain Injury, and Community Support. The waiver services themselves are delivered through the member's KanCare MCO; the waivers exist as the underlying federal authorization for those services, not as a separate delivery channel.
Integrated into managed care
Behavioral health is not carved out in Kansas. It is capitated directly into the same KanCare MCO contract as physical health and LTSS, delivered by whichever of the three MCOs a member is enrolled with.
Carved in
Dental is included in the standard KanCare MCO benefit rather than carved out to a separate statewide dental administrator; each MCO administers its own members' dental coverage directly. Adult dental coverage now includes exams, x-rays, cleanings, and dentures, with no annual benefit cap.
Kansas does not contract with a separate statewide pharmacy benefit manager. KDHE-DHCF sets a single Preferred Drug List directly through its own Pharmacy and Therapeutics Advisory Committee, and all three KanCare MCOs administer pharmacy claims against that same state-set list rather than maintaining independent formularies.
Non-emergency medical transportation is arranged through broker relationships each MCO maintains on its own, not a single statewide broker. ModivCare currently serves both Sunflower State Health Plan and UnitedHealthcare Community Plan of Kansas members across all 105 Kansas counties.
Gainwell Technologies operates the KMAP portal and serves as Kansas Medicaid's fiscal agent, including claims processing and provider enrollment. Gainwell also operates the Kansas Medicaid Modular System (KMMS), the state's modular MMIS/fiscal-agent platform, under an ongoing maintenance, support, and enhancement contract.
Last updated: Aug 29, 2026
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