[ad_1]
Iowa’s Medicaid benefits are administered by three health insurance companies, the state Department of Health and Human Services announced Wednesday.
The state announced its intention to award managed care contracts with Amerigroup Iowa and Molina Healthcare of Iowa. These new contracts will take effect when the state terminates its contract with Iowa Total Care, which expires in 2025.
These companies administer Iowa’s $7 billion program, which combines federal and state funding to provide health care assistance to more than 790,000 disabled and low-income Iowans.
Amerigroup and Iowa Total Care already manage care contracts with the state, but the new agreement paves the way for the future. While Iowa HHS announced the winning bids this week, the companies are still in negotiations to finalize the agreements.
According to Iowa Medicaid Director Liz Matheny, these new contracts take steps to eliminate problems in the state’s system. The Legislature voted to privatize Medicaid in 2016, a move that both medical providers and recipients say has created barriers to access to health care.
In the year Matheny, who takes over her current role in 2021, said she has spent the past year working with enrollees and health care providers to find out what the issues are. These new contracts will help improve Iowa’s Medicaid infrastructure, she said, in addition to other steps the department is taking.
“While this managed care announcement is huge and time-consuming, it’s just one part of a larger strategy and investment we’re making to improve the overall Medicaid program,” she said at a news conference Wednesday.
Changes to the contract include new requirements on continuity of care, better communication with health care providers on payment, and new tests for claims.
Privatized Medicaid presents challenges for patients, providers.
These new provisions come after the privatization process of the government program began. Iowa started out with three companies managing care contracts, but AmeriHealth Caritas dropped out in 2017 and UnitedHealthcare in 2019. Both companies reported significant financial losses as a result of their contracts with the state, while recipients reported being cut off for medical services.
Amerigroup is the only company that continues to provide services after the state’s privatization. Iowa Total Care came in after UnitedHealthcare left. Matney Molina said she was chosen to join these companies because of her experience providing managed care services in state insurance marketplaces, serving more than 5 million Medicaid and Medicare members nationwide.
“We really want to make sure we’re choosing an entity that has a proven track record and has shown positive results,” Matheny said.
Kelly Garcia, director of the Iowa Department of Health and Human Services, praised Molina’s role in Iowa’s Medicaid program and Matney’s work to improve the system.
“Under Director Matheny’s leadership, Iowa’s Medicaid program is truly addressing the needs of Iowans who trust us,” Garcia said in a statement. “It’s the right thing to do to make sure that those we serve and advocate for are included in the conversation, and the work we’re doing reflects that.”
But some critics argue that no matter which company manages the program, the privatized system itself will continue to cause problems.
“Private Medicaid has failed to save tax dollars or keep Iowans healthier,” State Sen. Sarah Thorne Garriott, D-Wakee, said in a statement. “Year after year, the Reynolds administration has disrupted the lives of Iowans by failing to provide proper oversight and accountability. Iowans need new leadership.
There are no immediate changes for Medicaid recipients. The four-year contracts announced with Amerigroup and Molina will begin July 1, 2023.
[ad_2]
Source link
