Beginning April 1, Iowans will have a new health care system to navigate as the state transitions from a fee-for-service Medicaid program — in which providers are reimbursed by the state for individual services — to a capitated managed-care system.
This means the state will pay an agreed-upon fee for each Medicaid recipient enrolled with the managed-care organizations, that will then reimburse providers for care. The change is expected to bring Iowa millions of dollars in savings in the first six months, according to the state, which will help stabilize costs and makes managing budgets easier. That’s one of Iowa’s main drivers behind the transition.
But opponents to the plan say the state already manages its Medicaid costs effectively, while many providers and recipients fear the move will result in fewer services and lower reimbursements.
While there are fears and disagreements on whether this is the right choice for Iowa, no one knows with certainty if the transition will be a boon or a bust. Other states have successfully implemented managed cares while others have met significant challenges.
To better understand the key developments in the transition so far, see the timeline below. In the Sunday edition of The Gazette, we'll introduce the Edbergs and their special-needs son, Colin, who are one of the many families affected by the transition, and follow them as they navigate the first year of managed care in Iowa.