Try 1 month for 99¢

DES MOINES — On Friday, UnitedHealthcare of the River Valley became the managed-care organization for the vast majority of Iowa’s Medicaid members following the withdrawal of AmeriHealth Caritas from the state’s program.

After the state announced all AmeriHealth members would be shifted to UnitedHealthcare, the department sent a notice to Iowa lawmakers stating Amerigroup did not have the capacity to take on any new members, including AmeriHealth beneficiaries who chose Amerigroup as their managed-care organization.

This left those 215,000 members with no choice for their Medicaid insurer.

UnitedHealthcare Community Plan of Iowa Chief Executive Officer Kim Foltz said the organization’s officials were focused on its members, making sure the company was “doing everything we can to ease their fears and anxiety they have with this transition.”

“Beyond that, our commitment is to serve these Iowans,” Foltz said. “We want them to understand the importance of them having choice. It would be our hope that we service them so well that their choice continues to be UnitedHealthcare.”

UnitedHealthcare already had some 167,000 enrollees on its books before accepting the 215,000 member from AmeriHealth. There are approximately 570,000 Iowans enrolled in the Medicaid managed-care program, according to the Department of Human Services.

UnitedHealthcare has been increasing internal case management staff and expanding its provider network across the state in preparation for the influx of members Friday.

Within days of AmeriHealth’s announcement, Foltz said UnitedHealthcare began to reach out to AmeriHealth case managers to recruit them. Several job fairs also have been held across the state by the company.

Officials intend to hire approximately 400 community-based case managers, who oversee individual Medicaid recipients and their health care services.

As of Monday, Foltz said, 257 case managers had been hired.

UnitedHealthcare also has reached out to provider networks that previously would not contract with the company for Medicaid, Foltz said.

Foltz said said the MCO uses the expertise and knowledge of the entire company, the Minnesota-based UnitedHealth Group, which manages Medicaid in 28 states.

During the first year of managed-care in Iowa, all three insurers reported losses in excess of $100 million. UnitedHealthcare, which has multiple lines of business in the state and does not file financials for its Medicaid business separately, stated it had lost more than $100 million last fiscal year.

Foltz said the losses can’t continue long-term.

Subscribe to Daily Headlines

* I understand and agree that registration on or use of this site constitutes agreement to its user agreement and privacy policy.

Load comments