State officials have chosen a California-based company to join two other private firms that manage Iowa Medicaid, the joint state-and-federal program that currently provides health care services to about 800,000 disabled and low income Iowans.
State Medicaid director Elizabeth Matney says Molina Healthcare’s contract will start July 1, 2023.
“They are actually entirely focused on government programs, so they only cover Medicare, Medicaid and the ACA marketplace plans,” Matney says. “Actually 80 percent of all of their covered lives are Medicaid, so they are incredibly specialized in the Medicaid space.”
The state is extending its current Medicaid contract with AmeriGroup. Iowa TotalCare’s contract for managing care for Iowa Medicaid patients runs through 2025. Matney says the goal is to divide Iowa’s Medicaid members evenly among the three managed care companies.
“We want to consider member choice up front and not create a situation where members have to switch back and forth, so we’re thinking through some of those logistics, “Matney says, “but really, ultimately, the goal is to have equal distribution across the three managed care organizations.”
Hospitals and other other health care providers in the state have complained that Medicaid claims are not always being paid on time. Matney says no system is perfect, but the contract with Molina sets clear deadlines.
“We’ll also be really strenuously monitoring their claims payment once they do go live to make sure they’re
meeting timelineness standards,” Matney says, “they’re meeting accuracy standards.”
Republican Governor Terry Branstad oversaw the shift to private management of the Medicaid program in 2016. State Senator Janet Petersen, a Democrat from Des Moines, says the contracts ensure profits for out-of-state companies while “health care services crumble across rural Iowa.”