Medicaid Managed Care in Iowa

posted by Chris Sparks on Friday, July 17, 2015

Last February, the Iowa Department of Human Services (DHS) released a Request for Proposals for Governor Branstad’s Medicaid Modernization. This plan aims to improve quality and access, achieve greater accountability of outcomes, and create more predictable Medicaid budgets.

Since February, the following updates have been reported.

• Iowa DHS has received 11 proposals from managed care organizations (MCOs).
• The Department estimates a Notice of Intent to Award will be published on or around August 7, 2015 - where 2 to 4 companies will be selected.
• After the companies are selected, families will have the opportunity to select the managed care company with which they would like to work.

What Does This Mean for EPI?

We know you and your family have a vested interest in Medicaid - we do too. It’s not just about dollars and cents lining up - it’s critical to someone you love.

Though EPI does not have influence over these Medicaid Modernization initiative decisions, we do want to be a resource for you and share what we can as we learn alongside of you.

We do anticipate MCOs analyzing the following:

• Preventable health conditions (wellness checkups, body mass index, hypertension, etc.)
• Individual service needs - likely resulting in reduced staff support
• Large, congregate services

Further, we anticipate an emphasis on natural supports with the dual goal of improving community inclusion and quality of life while managing costs.

As a company, we have spent the last few years getting ready for the expectations of the managed care organizations such as preventable health conditions, community integration, and natural supports to name a few.

EPI has taken multiple steps to prepare for Medicaid modernization, so you can count on us to be here.