Iowa Medicaid head offers methodology on savings estimates
Then, after making his presentation during the
Randol discussed the methodology for determining that
The nearly
It was not explained during the presentation why officials did not use actual costs from state fiscal year 2017 for this estimate.
Randol said the methodology he used created a more accurate estimate by changing the comparison. Managed-care costs previously were compared to the state's fee-for-service model --
"I think they were comparing to fee-for-service, but I felt it would be more appropriate to look at the Medicaid program as a whole prior to implementation and whole program after implementation (of managed care)," Randol said. "It's not appropriate to compare fee-for-service to managed care. We compared Medicaid to Medicaid."
But regardless of methodology, "there are savings," Randol said. He added that the department has to ensure the program is sustainable long-term for the thousands of poor and disabled Iowans who rely on Medicaid for their health care.
"We have to have that sustainable program, and to do that, you have to manage the care and manage the appropriate costs within the program," Randol told Council members. "And with the managed-care delivery program, I believe that's what we're seeing."
About 20 state officials, lawmakers, stakeholders, members of the media and the public attended the presentation.
Randol's presentation comes in response to calls for transparency after the new
Randol did not clarify in the meeting why these two estimates were different from one another, and did not take questions from reporters seeking explanation following his presentation.
Randol's office has not directly responded to earlier requests for a separate meeting with Gazette reporters to discuss the estimates.
Two Democratic lawmakers at Wednesday's meeting said Randol's presentation was vague and did not answer some lingering questions on the impact of these costs savings.
Sen.
"I don't think (anyone) in the room felt there was a clear answer where the savings were," Ragan told reporters after the meeting.
Sen.
"Certainly he provided some total numbers," Jochum said. "However, I believe we were not comparing apples to apples because if you look at pre-managed care and compare it to a projection of 2018 rather than comparing it to some actual real numbers from 2017 ..." a lot of unknowns remain.
She called on Randol to sit down with members of the media and provide more detail on the cost savings estimates of the Medicaid program.
Democratic lawmakers are looking to an incoming Iowa State Auditor's review, which was formally requested by Jochum following the release of the
In her letter to the State Auditor
"I am hoping that (Mosiman) is going to be able to go into the Medicaid system, collect the health data as well as the financial data to determine whether or not there are real cost savings, where it's coming from, whether or not we're actually engaged in care coordination and practicing preventive care that can reduce our health care costs," Jochum told reporters Wednesday.
DHS Director
"I think it's a huge plus," Foxhoven said. "If everyone is concerned whether or not we're getting real numbers, here's our way to find out."
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