A key state administrator says progress has been made to fix problems in the privately-managed Medicaid program that serves half a million Iowans, but Department of Human Services director Jerry Foxhoven says reverting to a system where state employees manage care for patients is not a fix he’s willing to make.
Private companies began managing the program in April of 2015.
“I don’t think there’s any question that managed care is the future, that most states are going to managed care. This is not uncommon,” Foxhoven said this afternoon. “Most states, early in their programs, have struggled with the program — some of the same issues that we’ve struggled with.”
Foxhoven testified before the Senate Human Resources Committee. Health care providers have complained about lagging payments for Medicaid services and patients say their complaints about denied care fall through the cracks. Foxhoven said the billing issue is getting better and, with “millions of claims” processed, there have only been a “couple of hundred appeals.” However, Foxhoven promised a “serious” review of those appeals.
“If you look at the program as a whole, we’re really doing quite well,” Foxhoven said.
Legislators of both parties pressed Foxhoven for data to back that up.
“I’m kind of surprised that you can’t give us anything more than a general statement that, ‘Yeah, things are getting better,'” Senator Julian Garrett, a Republican from Indianola, said.
After the meeting, Foxhoven told reporters there’s no infrastructure left to have state employees manage care for Medicaid patients.
“It’s like we’re not going to go back to rotary phones,” Foxhoven said. “…The world of Medicaid anymore is managed care. Everybody’s moving in that direction, not away from it, but towards it because it’s the only way you end up making it sustainable in the long term.”
Foxhoven told reporters his agency may ask legislators to approve “small changes” in Medicaid, but he didn’t specify what those might be. Foxhoven also indicated most of the adjustments he envisions for the Medicaid system can be made under his orders.