August 16th, 2019 BY HealthNetwork
UnitedHealthCare has announced that it plans to leave Iowa’s Medicaid program over the next few months, leaving as many as 425,000 residents without a healthcare insurer. In Dubuque, healthcare providers are concerned about the impact not only on their clients but also on their business.
On Friday, March 29, UnitedHealthCare announced that it was pulling out of IA Health Link, stating that Iowans who are currently on Medicaid will need to move their business to either Amerigroup of Iowa or Iowa Total Care. However, Iowa Total Care is not expected to begin offering services until July 1, 2019.
Healthcare providers expressed concern after the announcement and many reported that they were shocked at the decision. Some providers are still awaiting reimbursements from as far back as 2016. One provider stated that they continued to have issues with getting reimbursements from the Managed Care Organization (MCO) and getting errors corrected while experiencing additional problems over the past three years with the program.
The announcement that UnitedHealthCare is planning on leaving the Medicare system in the state has caused concern as families are now unsure who will be providing their Medicare coverage.
Providers say that when an insurer leaves a state, it presents major issues for both the provider and the patient. Families must choose a different insurer, make sure that the providers they are currently using accept that insurer, get new insurance cards and provide the new information to their healthcare providers.
Clinics, hospitals and doctor’s offices face a significant amount of administrative work as well. One report said that the administrative responsibilities can double the work for staff members. One provider estimated that administrative staff can work 60 to 80 hours per week when they must transfer a large number of clients from one insurer to another.
Those who receive long-term support are especially vulnerable to changes in healthcare providers. Many are asking state government to evaluate the system and make changes.
There are suggestions that the state use a coordinator case-managed care solution operated by the state as an insurance model rather than offering coverage through multiple insurance companies. The state could also return to a fee-for-service model, although providers and insurance experts feel that this is a less-effective solution.
UnitedHealthCare did not provide a timeline for when it planned to leave the IA Health Link program. The announcement indicated that the company was still working out details for the transition. The company plans to send notifications to all members to provide them with information about other options and an explanation on how to switch their Medicaid coverage to another company.
All IA Health Link program members are in Open Choice Period, which began March 4, 2019 and will end June 18, 2019. During the enrollment period, those on the program can choose which MCO they wish to enroll in for coverage that will begin July 1, 2019.