Since Iowa implemented its Medicaid managed-care program three months ago, it's estimated the state saved $22.2 million in spending. Iowa is on track to save more than $110 million in the program's first year, the Waterloo-Cedar Rapids Courier reports.
Here's what you should know.
1. Iowa's Department of Human Services reported this data through its quarterly report.
2. Iowa privatized its Medicaid program on April 1.
3. Since the privatization, Amerigroup, AmeriHealth and UnitedHealthcare received 145, 42 and 39 grievances respectively. The same three groups had 14, 52 and 49 appeals, respectively.
4. Capitation rates, fees paid to the MCOs, totaled more than $850 million. Amerigroup had $238 million, AmeriHealth $409 million and UnitedHealthcare was at $229 million.
5. UnitedHealthcare had the highest number of denied or suspended claims. In April, it had paid 49 percent of its claims and suspended or denied 51 percent. By June, it increased those numbers to 67 percent and 33 percent, respectively.
AmeriHealth approved 57 percent, suspended 30 percent and denied 13 percent in April. In June it had approved 75 percent, suspended 10 percent and denied 15 percent.
Amerigroup paid between 95 percent to 88 percent of its claims in the first three months. It had no suspended claims.
6. Concerning hospital reimbursement, Amerigroup paid hospitals $58.8 million in claims through the first quarter. AmeriHealth paid $23.4 million and UnitedHealthcare paid $47.1 million.
Amerigroup paid physicians $80 million, Amerihealth paid $20 million and UnitedHealthcare paid $3 million.
Amerigroup paid $24.9 million in home health claims, Amerihealth paid $5 million and UnitedHealthcare paid $2.7 million.
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