Providers, patients question transition

MARION — No better question illustrated the confusion over the state's Medicaid transition than when a woman asked Monday what Iowa Health Link is — the name of the state's new managed care Medicaid system.

More than 75 people packed the forum at the Marion Public Library to voice concerns and ask questions relating to the state's plan to transition its $4.2 billion Medicaid program — which includes almost 600,000 enrollees and about 30,000 health care providers — into a privately managed care system starting Jan. 1.

Four managed care companies — Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare Plan of the River Valley and WellCare of Iowa — signed contracts with the Iowa Department of Human Services on Oct. 9 to take over the program, formerly run by the state.

Many items remain to be figured out, including reimbursement rates to health care providers.

State officials have said the move could save a projected $51.3 million in the first six months. Critics, however, have questioned that number.

'This process is incredibly frustrating as a legislator,' said state Rep. Kirsten Running-Marquardt, D-Cedar Rapids, one of the legislators hosting the event. 'I'm concerned on several different levels.'

Running-Marquardt, along with state Sen. Liz Mathis, D-Robins, and Rep. Art Staed, D-Cedar Rapids, said they were worried the transition timeline is too aggressive and that medical services could be cut.

Those concerns were echoed by providers, caregivers and beneficiaries attending the meeting, who asked questions about the companies chosen to manage the program, if they'll be able to keep their doctors, and how the privatization will save the state money. There also were questions on the need for four companies, the difference in plans and what to do if the specialists people are seeing don't sign up for the same networks.

'We're being sent contracts to sign and being asked to abide by policies and procedures that have not been developed,' said Bob Hebl, executive director of Discovery Living, which provides residential services to more than 150 people with intellectual disabilities.

Hebl questioned the Jan. 1 deadline, adding he is worried about a delay in reimbursements, which non-profits rely on.

'Very few non-profits have more than a week's cash on hand,' he said. 'The speed by which this is being implemented, I promise you, will leave tens of thousands of people falling through the cracks.'

Providers from Linn County, the Eastern Iowa Health Center and the Area Substance Abuse Council also were worried over contract negotiations, saying the four companies chosen to manage the program have been difficult to get in touch with and unwilling to change clauses in contracts.