Three health systems sign Medicaid contract

With the New Year's Day Medicaid-transition launch date inching closer, two of the Corridor's largest hospitals have signed agreements with at least one managed-care organization, Gov. Terry Branstad announced on Thursday.

The University of Iowa Hospitals and Clinics, UnityPoint Health — which includes St. Luke's Hospital in Cedar Rapids — and Genesis Health System in the Quad Cities all have come to agreement with a managed-care organization.

The hospital systems represent about 3,000 Medicaid providers, the state said.

'These hospitals have signaled they are ready to provide quality care to Medicaid patients all over Iowa on Jan. 1, 2016,' Branstad said in a statement. 'We appreciate the commitment these hospitals are showing to Medicaid patients and their willingness to put politics aside and put sound policy and patients first.'

Branstad announced plans to transition Iowa's $5 billion Medicaid system to four out-of-state, private care companies earlier this year. In August, the state awarded contracts to Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare Plan of the River Valley and WellCare of Iowa.

Since then, many health care providers have expressed frustrations with the timeline — calling it rushed — and some have been cautious to sign contracts.

In addition, the Iowa Hospital Association filed a petition for declaratory judgment and injunctive relief with the Polk County District Court, asking the court to delay the implementation of managed care until a legal conflict is addressed.

State data shows that before Thursday's announcement few hospitals had signed with three of the four managed-care organizations — seven of the 118 signed with Amerigroup, five signed with AmeriHealth, and 20 signed with WellCare. UnitedHealthcare had the most contracts signed with hospitals — 48.

And with only days before federal officials visit Iowa to perform readiness reviews, the state and managed-care organizations must prove they have established adequate networks. The Centers for Medicare and Medicaid Services — which still must sign off on the move — will be in Des Moines next week to perform the reviews.

'We've made significant progress in expanding our network in the past two weeks, and we are very pleased to welcome three major health systems to the IA Health Link network,' Medicaid Director Mikki Stier said in a statement.

New data released Thursday by the Department of Human Services reveals that all four managed-care organizations have contracts with less than 50 percent of the state's 42,000 providers. However, the data does not include providers associated with Thursday's announcement.

As of Dec. 1, state data showed that Amerigroup had secured contracts with 41.6 percent of providers; Amerihealth with 31.2 percent of providers; UnitedHealthcare with 42.5 percent of providers; and WellCare with 27.6 percent of providers.

Late last week, an administrative law judge recommended the state throw out its contract with WellCare as she said the company used improper communication during the bidding process and did not initially disclose its legal troubles.

Branstad has said the ruling won't slow the transition. He has appointed Janet Phipps, director of the state Department of Administrative Services, to review the finding and render a decision.

The fact that the governor won't slow the process is concerning to those who have criticized his administration for the rate that it has implemented the change.

^{'The state's rush to implement this ill-conceived plan has forced hospitals to make hard decisions, but those decisions will always be made with the health and wellbeing of patients first and foremost," Scott McIntyre, vice president of communications and government relations for the Iowa Hospital Associatio, said Friday. "The same cannot be said of state's mad dash toward privatization. The fact that some providers are signing contracts at the 11th}

 hour, while thousands more have not signed contracts at all, speaks to an utter lack of confidence in the administration's plan. Hospitals, physicians, nurses, Medicaid beneficiaries and their families and Iowans everywhere have spoken loud and clear: this plan is unreasonable and unnecessary. Iowa hospitals will continue to oppose Medicaid privatization and fight for what is right for Iowa and what is best for Iowans.'

Summary highlights

Number of providers to sign a contract

Amerigroup

• Physicians — 2,715 out of 7,512 (36.1 percent)

• Occupational and physical therapists — 196 out of 900 (21.8 percent)

• Clinics and health centers — 38 out of 312 (12.2 percent)

• Pharmacy — 744 out of 747 (99.6 percent)

Amerihealth

• Physicians — 827 out of 7,512 (11 percent)

• Occupational and physical therapists — 129 out of 900 (14.3 percent)

• Clinics and health centers — 37 out of 312 (11.9 percent)

• Pharmacy — 674 out of 747 (90 percent)

UnitedHealthcare

• Physicians — 6,415 out of 7,512 (85.4 percent)

• Occupational and physical therapists — 157 out of 900 (17.4 percent)

• Clinics and health centers — 106 out of 312 (34 percent)

• Pharmacy — 590 out of 747 (79 percent)

WellCare

• Physicians — 3,051 out of 7,512 (40.6 percent)

• Occupational and physical therapists — 138 out of 900 (15.3 percent)

• Clinics and health centers — 64 out of 312 (20.5 percent)

• Pharmacy — 747 out of 747 (100 percent)

Source:

Department of Human Services data