Iowa set to launch new era of Medicaid

DES MOINES - State Medicaid officials answered legislators' questions and expressed confidence Wednesday that months of planning will succeed in moving government health care services for 560,000 Iowans to a privately managed system.

It all begins Friday.

Iowa Department of Human Services officials spent more than 90 minutes Wednesday trying to allay concerns members of a Senate panel. Some of those senators said they are still hearing from constituents with the changeover imminent. Speaking for the DHS were director Mikki Stier, chief financial officer Jean Slaybaugh and Liz Matney, the Medicaid managed care bureau chief. said they are still hearing from constituents with the changeover imminent.

'This is a big transition,” DHS spokeswoman Amy Lorentzen McCoy told reporters after the Senate Human Resources Committee hearing.

'We would anticipate that we're going to do a rollout that's going to help people have a relatively smooth transition because we've been doing so much planning,” McCoy added. 'When we have problems that do arise, we have processes in place to address them right away.”

Iowa has contracted with three private managed care organizations to take over the government-run system. Gov. Terry Branstad has said he thinks the new system will deliver services more efficiently to benefit recipients, providers and taxpayers.

Despite the assurances, some legislators expressed trepidation about the shift.

'I'm always hoping for the best,” said Sen. David Johnson, R-Ocheyedan. 'My biggest concern would be system overload and I think that's shared by a lot of senators. There are still a lot of questions.”

Sen. Mark Chelgren, R-Ottumwa, came away from Wednesday's meeting with similar feelings.

'I think we're going to have a minor catastrophe on our hands, but I also think it's one of those things where it's inevitable and the challenge we have at this point is the longer we drag it out, the more pain we're going to cause,” he said. 'It's kind of like pulling a Band-Aid off. You want to do it quickly and then solve the problem as quickly as you can so we inconvenience and hurt as few people as possible.”

Sen. Liz Mathis, D-Robins, committee chairwoman, implored the agency to 'have operators standing by all weekend” to avoid the potential for a 'disaster” if confused Medicaid members aren't able to function in the new environment.

'There are many, many systems involved with Medicaid, hundreds of IT systems and programs, call centers,” McCoy noted, 'and we're going to trouble shoot where we need to trouble-shoot to do what we need to do for our members and try to get them served immediately.”

Chelgren said part of the challenge will be for individuals who are used to a fee-for-service arrangement. It now will function under a system similar to private insurance in which they will work with a primary provider or deal with co-pays and services that might be in or out of network.

Sen. Amanda Ragan, D-Mason City, said there a disconnect persists between the information lawmakers are getting from DHS officials and managed care executives and the reports that legislators are receiving from their communities.

'We're still uncertain as to how it's all going to flow,” she said. 'I think there will still be some confusion.”