DES MOINES -- UnityPoint Health said Wednesday it may not renew its contract with Amerigroup of Iowa, one of two remaining Medicaid managed care organizations in the state.

The decision could affect 54,000 patients.

“We are disappointed that our contract issues with Amerigroup are not yet resolved and know the announcement of a possible change may cause confusion for our Amerigroup patients,” Sabra Rosener, vice president of government and external affairs for UnityPoint, said in a statement.

UnityPoint said it’s still negotiating with Amerigroup and hopes to reach an agreement by the end of the year, but wanted to let patients know about the situation so they could think about making changes.

A company spokesperson would not comment further.

If its contract with Amerigroup isn’t renewed, UnityPoint would no longer be part of the insurer’s provider network beginning Jan. 1. Starting April 1, UnityPoint said, its hospitals, clinics and home care services would no longer be available to Amerigroup members except for emergency care required by law.

UnityPoint said it is currently providing care to Amerigroup members as usual and will continue with United Healthcare, the other remaining managed care organization in the state.

A spokesman for Amerigroup, Tony Felts, characterized negotiations with UnityPoint as “productive.”

“We are optimistic that we can come to an agreement that will be beneficial to Medicaid enrollees, the Medicaid program and to the taxpayers of Iowa,” he said.

It is the latest development in the state’s controversial conversion of its $5 billion Medicaid program to managed care. Former Gov. Terry Branstad initiated the change, which took effect last year.

Since then, insurers have reported significant financial losses, while some health care providers have complained bills have gone unpaid.

Last month, AmeriHealth Caritas, one of the three private companies that signed on to manage the state’s Medicaid program, announced it was pulling out effective Dec. 1. That is affecting about 215,000 Iowans.