Iowa Medicaid payment shortages are 'catastrophic,' private managers tell state

[TexasTowelie]

The for-profit companies running Iowa’s Medicaid program have been complaining to state administrators that the controversial project is “drastically underfunded” and that the situation has been a “catastrophic experience,” newly released documents show.

One managed care executive wrote that Iowa’s recent offer to give the companies an extra $127.7 million in state and federal money this budget year “is not acceptable.” He added that without major changes, the privately run Medicaid program could be unsustainable. None of the three companies has agreed to accept the size of the increase in money they would receive for covering poor and disabled Iowans.

“We are extremely disappointed in the amended rate offer, as it does not address the significant rate issue identified and documented. … The department’s rate offer is not actuarially sound and is not acceptable to us,” AmeriHealth Caritas Regional Vice President Russell Gianforcaro wrote on Oct. 27 to Department of Human Services Director Charles Palmer.

The companies’ complaints were included in recent memos and emails The Des Moines Register obtained under the state’s open-records law. The three companies, Amerigroup, AmeriHealth Caritas and UnitedHealthcare, told state officials that their reimbursement rates were based on deeply flawed cost estimates provided to them before the project began.

Read more: http://www.desmoinesregister.com/story/news/health/2016/12/21/iowa-medicaid-payment-shortages-catastrophic-private-managers-tell-state/95697880/

[OldRedneck]

1. Would be interesting to see . . .

. . . the salaries and perks provided to the executives of these three companies as well as the bonuses handed out to everyone on the payroll.

[Sancho]

2. The big elephant in the room of the US health care system is simple...

our medical professionals are paid much higher salaries than most public systems! When you add in "for profit" hospitals, drug companies, and insurance companies there is no way to get control. That includes the high paid administrators.

Any public system would pay doctors, nurses, etc. 1/3 to 1/3 less than many are making today. Likewise, a public administration would be much more streamlined; fewer paper pushers and less choices.

Right now there is a drug store, hospital, clinic, etc. on every corner in most profitable urban centers. A public system would be streamlined and health care professionals would be paid salaries most likely instead of fee for service.

[progressoid]

3. Asshole fucks up the state and then pads off to China.

Remember when he said it would save 51 million in the first six months?

I really hope Democrats use this in two years. We can't afford to keep electing these crony Republicans.

[rurallib]

4. hope they start using it today!

and hammer, hammer, hammer on it ad nauseam