A big shift is coming in just two weeks for thousands of Iowans who rely on the state for health care. Four private companies will manage the care of current Medicaid users, starting January first.
But some say the change at the top could have a negative impact on services provided to people with developmental and intellectual disabilities.
At VODEC, in Council Bluffs, staff teaches job and life skills to clients with varying levels of disabilities. Each of these clients has an individual treatment program VODEC staff provides those services and the company then bills the Iowa Medicaid system.
With the coming changes in Iowa’s Medicaid program providers like VODEC worry they'll be paid less for the same services.
Ahead of the public to private shift, the state is implementing a new re-imbursement system that changes how companies will be paid. It is based on a complex system that averages out the cost of care for a person.
VODEC CEO Steve Hodapp says the new model will result in lower payments for more-involved services provided to people with severe disabilities. “So in other words there will be some providers, like us, who are providing one-to-one service now for whom the new rate structures not going to work anymore.”
State officials say the rate change isn't designed to cut costs but to increase billing efficiency.
“Previously we had in place many thousands of different rates, this is not a great business model for being able to do reimbursements,” said Amy McCoy, a spokesperson for the Iowa Department of Human Services. “So this is something we've looked at for sometime being able to stream line this process a bit more.”
The state says its research shows the impact of the new rates on providers will be low.
“When we look at the data on the average weighted rates we see less than a one percent change for the majority of our providers,” said McCoy.
But Hodapp fears the impact of the cuts may be bigger than expected and his clients will suffer for it. “All I know is we have some consumers from whom we're going to get paid significantly less in January than we're being paid in December and the expectation is we provide the same service and I don't know how we're going to be able to do that.”
VODEC has appealed the re-imbursement rates to the state and is awaiting a response. Hodapp added he believes in the long run the situation will work out, citing the previous changes in the state healthcare system he’s experienced during his 18 year tenure at VODEC.
The state and the four companies Iowa has hired to run the Medicaid system say they're committed to maintaining the same level of care for everyone in the system.
