UnitedHealthcare CEO confident heading into 2018

On Friday, UnitedHealthcare of the River Valley became the managed-care organization for the vast majority of Iowa's Medicaid members following the withdrawal of AmeriHealth Caritas from the state's program.

After the state announced all AmeriHealth members would be shifted to UnitedHealthcare, the department sent a notice to Iowa lawmakers stating Amerigroup did not have the capacity to take on any new members, including those AmeriHealth beneficiaries who chosen Amerigroup as their managed-care organization.

This left those 215,000 members with no choice for their Medicaid insurer.

UnitedHealthcare Community Plan of Iowa Chief Executive Officer Kim Foltz told The Gazette Friday the managed-care organization's officials were focused on its members, making sure the company was 'doing everything we can to ease their fears and anxiety they have with this transition.”

'Beyond that, our commitment is to serve these Iowans,” Foltz said. 'We want them to understand the importance of them having choice. It would be our hope that we service them so well that their choice continues to be UnitedHealthcare.”

UnitedHealthcare already had some 167,000 enrollees on its books before accepting the 215,000 member from AmeriHealth. There are approximately 570,000 Iowans enrolled in the Medicaid managed-care program, according to the Department of Human Services.

UnitedHealthcare has been increasing internal case management staff and expanding its provider network across the state in preparation for the influx of members Friday.

Within days of AmeriHealth's announcement, Foltz said UnitedHealthcare began to reach out to AmeriHealth case managers to recruit them. Several job fairs also have been held across the state by the company.

Officials intend to hire approximately 400 community-based case managers, who oversee individual Medicaid recipients and their health care services.

As of Monday, Foltz said, 257 case managers had been hired and started as early as this past Monday.

UnitedHealthcare also has revisited provider networks that previously would not contract with the company for Medicaid. Foltz said the company reached out to those providers they were not contracted with and asked, '‘does this situation present an opportunity to work together?'”

Foltz said a few provider networks 'in key areas” - including Medical Associates of Dubuque - have signed on with the company and are available for members.

UnitedHealthcare taking on 215,000 new members is an opportunity for the company to demonstrate 'our commitment to Iowa,” Foltz said.

She said the MCO use the expertise and knowledge of the entire company, the Minnesota-based UnitedHealth Group, which manages Medicaid in 28 states.

'We have the ability to leverage not only local resources and what we've been doing today and the expertise that we have here, but also the experience and resources of our national team that can help support us and really mobilize around a challenge like this that we see as an opportunity,” Foltz said.

During the first year of managed-care in Iowa, all three insurers reported losses in excess of $100 million. UnitedHealthcare, which has multiple lines of business in the state and does not file financials for its Medicaid business separately, stated it had lost more than $100 million last fiscal year.

Foltz said the losses can't continue long-term with out hindering the sustainability of the program, and that the company is continuing to work with the state on those issues.

'Sustainability is important for the health of the program as well as the health of the individuals it is serving,” she said. 'We continue our work with the state to ensure our program is appropriately and adequately funded to serve the needs of the individual that it's serving.”

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