UnitedHealthcare of the River Valley, an Iowa Medicaid managed care organization, is under new leadership.
Company officials confirmed to The Gazette Tuesday morning that Kim Foltz, the chief executive officer of the UnitedHealthcare Community Plan of Iowa, is leaving the company “to pursue other opportunities.”
“We thank (Foltz) for her contributions as she has played an important role in establishing the Community Plan of Iowa, which serves more than 400,000 people and their communities,” according to a statement from UnitedHealthcare.
The company did not comment on the nature of Foltz’s departure or why she has left the company.
“Kim Foltz has been an integral part of the implementation and development of the IA Health Link managed care program,” Iowa Department of Human Services Spokesman Matt Highland said. “The department thanks her for her contributions and wishes her the best in her future endeavors.”
Bror Hultgren will serve as interim CEO, effective immediately.
Hultgren, previously served as a senior vice president for UnitedHealthcare’s Medicaid business Community and State. He also concurrently served as chief executive officer of TeamMD, a Minnesota-based health care organization that offers primary care provider and care management services for low-income frail, elderly and disabled populations.
Before joining UnitedHealthcare in 2000, he worked in local and state government roles.
Hultgren earned a Bachelor of Arts degree in psychology from Hobart College in New York as well as a Master of Business Administration and a master of science in health administration from the University of Colorado at Denver.
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UnitedHealthcare, one of two private insurers that serve as managed care organization for the state’s Medicaid program, oversees 418,251 members — the majority of the approximately 600,000 Iowans who rely on the program for their health insurance, according to the latest report released by DHS.
The private insurer recently had undergone a major growth in its membership after former Medicaid administrator AmeriHealth Caritas exited the program at the beginning of this year, leaving UnitedHealthcare and Amerigroup Iowa as the only companies administering Medicaid in Iowa.
DHS since has selected Iowa Total Care — a subsidiary of Centene Corp. — as the third managed care organization. It will begin administering coverage to members on July 1, 2019.
UnitedHealthcare, which is managed by parent company UnitedHealth Group, has multiple lines of business in the state and is not required to file a separate report for its Medicaid business.
However, the company has stated publicly it anticipated losing more than $100 million in its first year under the managed care program, when it was switched from the state-run system.
UnitedHealthcare reported a medical loss ratio — or the percentage of capitations payments used to pay medical expenses — of 97.7 percent; and an administrative loss ratio — or the percentage of payments used to pay administrative expenses — of 10.9 percent in the third quarter report for state fiscal year 2018, according to DHS reports.
By comparison, in the same quarter of 2018 Amerigroup reported a medical loss ratio of 104.5 percent and an administrative loss ratio of 9.6 percent.
Iowa’s Medicaid program has drawn sharp criticism since it privatized in April 2016, particularly from enrollees who say their services have been reduced or cut and from providers who claim they are not being reimbursed by the insurers properly.
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DHS officials have said the state of Iowa is saving $140.9 million this fiscal year by privatizing Medicaid. But critics — including Iowa Hospital Association President and Chief Executive Officer Kirk Norris — contends the state has no data to support that claim.
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