Branstad touts Medicaid contracts, but few hospitals signed
Tony Leys, firstname.lastname@example.org 6:17 p.m. CST November 19, 2015
Gov. Terry Branstad, who is pushing to shift management of the state’s Medicaid program to private companies on Jan. 1, said Thursday that the firms have signed more than 12,000 contracts with pharmacies, doctors and other health care providers.
But most Iowa hospitals and physicians have not signed contracts to participate in the new system, according to the Department of Human Services. The issue is important, because the managed-care companies are supposed to show they have broad networks of health care providers willing to care for the new plans' members.
Branstad, a Republican who is seeking federal approval of the shift, touted the managed-care companies’ progress in signing up health care providers. He said 99 percent of pharmacies that serve the current Medicaid program are signed up with at least one managed-care company, and hundreds of long-term care services are on board.
“We are proud of our progress and we will keep working to serve Medicaid patients,” he wrote in a press release Thursday.
DHS released to The Des Moines Register on Thursday numbers showing that few hospitals have signed such contracts, however. None of the four managed-care companies reported signing more than 17 of the 118 Iowa hospitals now participating in Medicaid. One of the companies, WellCare of Iowa, said it hadn’t signed up any hospitals. Another, AmeriHealth, said it had signed up just two.
The managed-care companies reported signing contracts with from 200 to 1,116 physicians out of 6,685 who now provide care to Iowa Medicaid patients.
Leaders of several large hospital systems, including UnityPoint Health, Mercy-Des Moines, and University of Iowa Hospitals, have told the Register this week that they haven’t signed contracts with the managed-care companies.
The 12,000 figure cited by Branstad is the total number of contracts signed, not the number of health care providers who have agreed to participate. Each provider can sign up to four contracts.
Branstad contends the shift to managed-care companies will save millions of dollars for the state and federal governments while offering flexibility and coordinated care to Medicaid recipients.
Critics fear the change to for-profit management will lead to service cuts. They say Iowa’s 560,000 Medicaid recipients are being put in the impossible position of choosing a managed-care plan next month without knowing whether their doctors, hospitals and other health care providers will be participating in any of the networks.
Critics have asked federal administrators to at least delay the shift to private management. The Iowa Hospital Association has taken the matter to court, and Democratic legislators went to Washington, D.C., this week to plead their case with Obama administration officials.
Sen. Joe Bolkcom, an Iowa City Democrat serving on a committee monitoring the shift, said Thursday that the 12,000 figure touted by Branstad is unimpressive. He said that in a recent meeting, the managed-care companies said they each needed to sign up about 35,000 health care providers.
“It’s unbelievable that Gov. Branstad and Lt. Governor Reynolds would claim that it’s good news for Iowans that fewer than one-third of Iowa’s Medicaid providers have signed up for their proposed Medicaid privatization program,” Bolkcom wrote in a news release. “It is actually bad news because the effect of such low participation by health care providers would be to prevent hundreds of thousands of Iowans from accessing affordable, quality health care.”
According to the latest DHS figures, each managed-care company has signed up from 7 percent to 37 percent of the health care providers currently serving Iowa Medicaid recipients.