Iowa Medicaid program transitions to managed care

Iowa’s Medicaid program is currently in the process of transitioning to managed care, called “Iowa Health Link.”

Over the last few years, the Medicaid budget has been a budgetary challenge for the state because of costs increasing and money from the federal government decreasing. The cost of delivering this program has grown by 73 percent since 2003. Medicaid expenditures are currently projected to grow by 21 percent in the next three years.

With all of these challenges facing the state, in 2015, Gov. Branstad decided to transition the Medicaid program to a managed care system.

In a managed care system, Iowa Medicaid Enterprise will contract with managed care organizations (MCOs) to pay for health care services. These MCOs will then contract with providers across the state to provide care to Medicaid recipients.

The goal of the program is to improve quality and access, have greater accountability for outcomes and create a more predictable and sustainable Medicaid budget for the state.

On Monday Aug. 17, the Department of Human Services issued a notice of intent to award contracts for the following four managed care companies: Amerigroup Iowa, AmeriHealth Caritas Iowa, UnitedHealthcare Plan of the River Valley and Wellcare of Iowa. These contracts will be finalized in September.

The Medicaid program currently serves nearly 600,000 Iowans each year, which is about 22 percent of Iowa’s population. Currently, Iowa Medicaid Enterprise is the state’s second largest health care payer. The amount of $4.2 billion is spent each year on Medicaid services. The managed care program is set to begin on Jan. 1, 2016.