More details still needed about Medicaid

Officials have announced they'll be handing an additional $33.2 million to the three private companies that manage Medicaid for the state, yet insights into the particulars of the new program remain in short supply.

They say that unforeseen circumstances - including higher than anticipated prescription drug prices and unexpected health care expenses related to new Medicaid enrollees - prompted them to increase the companies' per-patient funding.

'Our actuaries underestimated in this case what the cost was,” Gov. Terry Branstad's Chief of Staff Michael Bousselot told reporters this week. 'So our experience will grow over time, and we'll have a better understanding of how this works.”

But the administration missed an opportunity to use this change to demand more transparency and accountability from the managed care organizations - ensuring that Iowans would have a better understanding of how Medicaid privatization is working, and where it's falling short.

We all want cost-efficient management of Medicaid, which provides health care services to roughly 600,000 Iowans, but it's been difficult to determine if the switch to private companies meets that standard. So far, there's been little insight into whether the system is meeting the needs of Medicaid consumers, delivering promised budget savings, or efficiently processing legitimate claims.

The first quarterly report on the program included few details. Iowans were told, for instance, that 99 percent of 'clean claims” were paid within 21 days, but we weren't told exactly what 'clean claims” are, or whether partial payments were included in that statistic.

Sadly, that's only one of many examples of how optimistic rhetoric isn't being backed up by clear statistics, or reflected in the experiences shared by many Medicaid providers and consumers.

Next year's state budget was built upon the Medicaid savings the Branstad administration has promised privatization will bring. We hope those savings materialize, because if it isn't, the money will still need come from somewhere. More important, Iowa taxpayers shouldn't be left to only hope.

Every Iowa family understands how difficult it can be to develop a budget and stick to it. When me with unexpected expenses, they can't rely on promises. They have to do the math and make the numbers work.

State government must show they're doing the same.

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