How will Managed Care Affect My Loved One?
posted
by Chris Sparks on Wednesday, July 8, 2015
Earlier this year Governor Branstad introduced plans to hire private managed care organizations (MCOs) to run Iowa’s Medicaid program. His plan is also known as the Medicaid Modernization initiative (also referred to as the Iowa Quality Health Care Initiative).
We know you and your family have a vested interest in Medicaid – we do too. And, we know for you it’s not just about dollars and cents lining up on a page – it’s critical to someone you love. While Exceptional Persons, Inc. (EPI) does not have influence over these Medicaid Modernization initiative decisions, we do want to be a resource for you. We will share what we can as we learn alongside of you.
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| Where can I look for credible, up-to-date information? | The Iowa Department of Human Services – Medicaid Modernization website: https://dhs.iowa.gov/ime/about/initiatives/MedicaidModernization |
| What are the goals of Medicaid Modernization? | The main goals of Iowa’s Medicaid Modernization are: - Improving quality and access
- Achieving greater accountability for outcomes
- Creating a more predictable and sustainable Medicaid budget
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| When does Medicaid Modernization take effect? | January 1, 2016. Here’s the timeline as we know it today: - Eleven MCOs have submitted proposals for consideration (you can access the list of 11 bidders through the news release found at the DHS link given above)
- The Department estimates a Notice of Intent to Award will be published on or around August 7, 2015 (2-4 companies will be selected).
- After the companies are selected, families will have the opportunity to select the managed care company they would like to work with.
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| How will this affect persons with disabilities? | Each person and their situation is unique – it will be up to the MCO you’ve selected to make this decision. 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. |
| How will this affect EPI? | EPI has spent the last few years getting ready for the expectations of the MCOs (as references above – preventable health conditions, community integration, natural supports, etc.). Additionally, we’ve taken measures to be financially healthy – you can count on EPI to be here. |
You’re likely to have questions as time goes on, while EPI will share what and when we can, your best source of information will continue to be the Department of Human Services and the Managed Care Organizations once they are selected.
If we can be of further assistance, please feel free to reach out to our Services Director, Susan Seehase (susan.seehase@episervice.org), or myself (chris.sparks@episervice.org) at (319) 232-6671. Thank you for allowing us to be of service to you.
*‘Managed Care,’ is also referred to as ‘Medicaid Managed Care’ or ‘High Quality Health Care Initiative.’