Unit­edHealth­care among in­sur­ers blast­ing Iowa’s man­aged-care pro­gram

Modern Healthcare - - REGIONAL NEWS - —Maria Castel­lucci

Iowa’s con­tro­ver­sial pri­va­tized Med­i­caid pro­gram is fac­ing in­tense scru­tiny and fi­nan­cial con­cerns from the health in­sur­ers that run it—An­them’s Ameri­group, Amer­iHealth Car­i­tas and Unit­edHealth­care.

The Des Moines Reg­is­ter ob­tained doc­u­ments that show the in­sur­ers have said the Med­i­caid man­aged-care pro­gram is “dras­ti­cally un­der­funded” and likened it to a “cat­a­strophic ex­pe­ri­ence.”

The Iowa De­part­ment of Hu­man Ser­vices out­sourced its $4.2 bil­lion Med­i­caid pro­gram this year, hop­ing to save the state $110 mil­lion in tax­payer dol­lars by the end of fis­cal 2016 in June. In­sur­ers have writ­ten to state of­fi­cials to ex­press con­cern that cur­rent re­im­burse­ment rates are flawed.

The state up­dated cap­i­ta­tion rates in Oc­to­ber to bet­ter re­flect spend­ing trends, par­tic­u­larly drug costs, said Amy McCoy, a state spokes­woman, in a pre­pared state­ment.

The in­sur­ers say they’ve lost mil­lions of dol­lars since Health Link be­gan. The Des Moines Reg­is­ter re­ported the state of­fered the com­pa­nies an ex­tra $127.7 mil­lion, but one in­surer ex­ec­u­tive said it “is not ac­cept­able.”

In a pre­pared state­ment, a Unit­edHealth­care spokesman said, “Sus­tain­abil­ity is crit­i­cal to the long-term health of both Iowa’s Health Link pro­gram and the many peo­ple it serves, and we con­tinue to work with the state to en­sure the pro­gram is ap­pro­pri­ately funded.”

Both Iowa Gov. Terry Branstad, a Repub­li­can, and the Iowa De­part­ment of Hu­man Ser­vices main­tain Health Link will save money while im­prov­ing qual­ity of care and out­comes for the 600,000 res­i­dents it serves.

Branstad says Health Link will save money and im­prove care.

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