Molina, Elevance nab Iowa Medicaid contracts on heels of California win

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Dive Transient:

  • Iowa will quickly have three well being insurers to handle its $7 billion Medicaid program. Elevance and Molina have received contracts to ship managed care within the state starting subsequent summer time, Iowa introduced Wednesday.
  • Iowa plans to award the four-year contracts to Elevance’s Amerigroup Iowa, which already has a Medicaid contract within the state, and newcomer Molina Healthcare of Iowa, beginning in July 2023, the Division of Well being and Human Companies mentioned.
  • Iowa Complete Care, which is owned by Centene, has a managed care contract with Iowa that lasts by means of 2025.

Dive Perception:

Beginning subsequent yr, Centene, Elevance and Molina will assist managed Iowa’s Medicaid program, which helps greater than 790,000 low-income residents of the state.

It’s Molina’s first contract within the Hawkeye State, because the California-based insurer continues to seize Medicaid market share following final week’s California win. California — the biggest Medicaid market within the nation — additionally awarded Medicaid contracts to Elevance and Centene.

Centene misplaced contracts in three counties, together with Los Angeles, inflicting shares within the firm to flag. The insurer voiced disappointment over the choice, and mentioned it was evaluating all choices to attraction.

Iowa mentioned the addition of a 3rd managed care group to its Medicaid program ought to improve selection for shoppers, and assist the state because it appears to extend neighborhood providers, enhance maternal well being, help foster care by means of Medicaid and enhance administrative providers.

The state legislature voted to denationalise Medicaid in 2016 in a controversial choice, as suppliers mentioned handing this system over to for-profit entities would create obstacles to healthcare entry. Initially, three payers held managed care contracts, however AmeriHealth Caritas withdrew in 2017 and UnitedHealthcare in 2019, citing main monetary losses as a result of their contracts within the state.

5 distributors bid for contracts following Iowa’s request for proposals in February. Of these bidders, Aetna Well being of Iowa and nonprofits CareSource Iowa and UCare Iowa weren’t chosen.

DHHS didn’t say why these bidders didn’t obtain contracts. However in response to a Des Moines Register overview of the proposals, officers discovered weaknesses in particular person functions, together with restricted managed care expertise and lack of specifics on how initiatives can be carried out.

The contracts awarded Wednesday are price roughly $6.5 billion annually.

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