Transformation of state Medicaid to private Managed Care


In February, 2015, the Iowa Department of Human Services (DHS) put out a Request for Proposals (RFP) for Governor Branstad’s Medicaid Modernization.    This is another way of saying Medicaid is going to be Managed Care  services, which came about without any input from legislators nor the public or knowledge of this, only in rumors, a true Branstad manner.    The conversion by private company (ies) is supposed to coordinate care, improve quality of services while insuring the bottom line of saving money, satisfying a long time Branstad’s complaint that Medicaid cost too much.


The Managed Care techniques could form a way to improved services and predictable costs only if the service delivery system is carefully designed, taking into consideration individual need, and effectively implemented.    The cost savings should be achieved by improving health outcomes and efficiency of care not by reduction or inaccessibility of services.  Managed Care’s goal of cutting costs caused the very real fear of detrimental effects on services.    This result of bad effects on services can be avoided by assuring individuals served have input and control of their care, which has an organizing goal of assisting them to live in their community.    Managed Care states this would be provided if funds are available.


SF 452, which passed in the Senate overwhelmingly, would create a state legislative oversight commission to monitor the transformation of Medicaid to Managed Care to ensure emphasis on choice, consumer-driven and community-based care will be maintained.    Hopefully, some version of this bill will pass out of the Iowa House.

By Kathleen O’Leary