AmeriHealth Caritas to leave Iowa Medicaid system, jettisoning nearly 213,000 beneficiaries

The total of Iowa’s privatized Medicare Managed Care Organizations (MCOs), responsible for handling the state’s nearly $4 billion in Medicaid expenditures, annually, now sits at two, with the recent 30-day notice that AmeriHealth Caritas will leave the state entirely.

On Tuesday, October 31, AmeriHealth Caritas notified Iowa Department of Human Services (DHS) that it would not return to the state to be a part of the privatized Medicaid system, due to lost profits in covering beneficiary costs. Out of all three MCOs, AmeriHealth had the highest number of beneficiaries at approximately 213,000, followed by AmeriGroup’s nearly 187,000 and UnitedHealthcare’s 1687,000, according to DHS records.

DHS is currently in the process of reallocating the 213,000 beneficiaries between the remaining two MCOs. According to Franklin County Community Services Director Russell Wood, the reorganization is completely random, and two different insurers could handle beneficiaries in the same family. Wood said that beneficiaries would have until the end of the year to confirm whether or not they wish to remain with the result of the random assignment, or pick the other MCO.

Read the full story in the November 8 edition.