Iowa Medicaid insurers pay more in claims than they get from the state
The quarterly report -- which details a number of metrics, including claims payments, prior authorizations and hospital admissions covering
The state handed over its
Medicaid By the Numbers
Click here to view
UnitedHealthcare of the
For two of three insurers, the losses were not as large as they saw in the previous quarter. According to the
- Amerigroup Iowa reported the highest loss of 27.6 percent, up from a 17.78 percent loss during the past quarter. The state paid the insurer
The company reported a medical loss ratio -- or the percentage of capitations payments used to pay medical expenses -- of 116 percent; and an administrative loss ratio -- or the percentage of payments used to pay administrative expenses -- of 11.6 percent. It paid more than
- AmeriHealth Caritas Iowa reported a loss of 16.6 percent, down from the 20.7 percent loss it reported during the past quarter. The state paid the insurer
The company reported a medical loss ratio of 110 percent and an administrative loss ratio of 6.8 percent. It paid more than
- UnitedHealthcare of the
The company reported a medical loss ratio of 99.7 percent and an administrative loss ratio of 11.9 percent. It paid more than
The state still projects saving
The state and MCOs have disagreed on whether the rates the insurers are receiving are adequate. The state maintains the rates are actuarially sound and that some losses were anticipated start-up costs, while the MCOs believe the program is underfunded.
Next month, the state and MCOs will begin negotiating rates for the rate period that begins
In late October, the state announced it would boost rate payments to the insurers by
And
A Gazette review of
- Amerigroup has been paid more than
-
- UnitedHealthcare was paid
Gov.
"But they're in it for the longer term, we're in it for the long term and we want to work together as partners to deliver the best care for our citizens," he said.
l Comments: (319) 398-8331; [email protected]
Below is a snapshot of the data, which The Gazette will update as new reports are released. To view the full reports, click here.
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