Tune into Iowa’s Medicaid changes, they’ll affect you

Tune into Iowa’s Medicaid changes, they’ll affect you

Almost everyone agrees that health care costs continue to increase. Everyone who pays the bills for health care is looking for ways to better control these costs. This includes the state of Iowa.

Gov. Terry Branstad has directed the Iowa Department of Human Services to transition the majority of Medicaid recipients to a new managed care program titled Iowa Health Links. The goals of Iowa Health Links are to improve the coordination and quality of care statewide, control costs, and help Iowa become healthier.

As a part of this program, four private companies (Managed Care Organizations or MCOs) have been selected to manage health care services for citizens who currently utilize the Medicaid program for health services. This program becomes effective on Jan. 1, 2016, less than three months from now.

Converting to Iowa Health Links is resulting in big changes for health care providers state-wide like nursing facilities, physicians, and hospitals. The majority of providers are currently in discussions with these four MCOs to become members of each company’s network.

This involves an extensive application process and signing a contract.

Converting to Iowa Health Links will also result in big changes for people who are currently Medicaid recipients.

Virtually every recipient will be enrolled into one of the four MCOs. If you don’t select an MCO, you will be assigned one by DHS. That MCO is then responsible to make sure each member receives complete individualized health care from that MCO’s provider network.

If you see a provider that is not a member of your MCO’s network, your health care will not be paid. Each member’s benefits will not change as long as eligibility remains. However, the member’s provider may change if the provider chooses not to contract with the MCO.

As an example, if your physician is not a member of your network, you will need to change physicians. Medicaid recipients do not need to do anything right now. But you need to watch your mail for letters from Iowa Health Links as they will notify you regarding what actions you need to take and when.

If you are a Medicaid recipient, don’t put your head in the sand. Please realize that this change is coming and does affect all Medicaid recipients throughout the state including Charles City and Floyd County. If you are a Medicaid recipient, it will affect YOU!

At Chautauqua Guest Homes, informational letters have been sent to affected residents and we will be assisting them throughout this process. I’m confident other providers have been or will be doing the same. In addition, informational meetings are being held throughout the state by the Department of Human Services. The next scheduled meeting in the Charles City area will be held in Mason City at North Iowa Area Community College on Friday, Oct. 30 from 5-7 p.m. in Room MH104G.

If you are a Medicaid recipient, consider attending this meeting.

Also Medicaid recipients with questions can call the Iowa Medicaid Member Services Unit at 1-800-338-8366 with questions.

Change is always difficult.

Working together, Iowa Medicaid recipients and Iowa health care providers will do our best to make this change positive for all involved. Stay tuned.

Sue Ayers, RN, BSN, Administrator, Chautauqua Guest Homes, Inc.

Sue Ayers

Guest Columnist