In a recent report released by Iowa Auditor Mary Mosiman, the latest estimates of what the state has saved using privatization of Medicaid was $141 million this past May, according to the Department of Human Services.

Despite that estimate, local entities are claiming the privatization of Medicaid still isn’t working. Greene County Medical Center CEO Carl Behne says they are still seeing denials for portions or entire services from the Managed Care Organizations (MCOs) that control the state’s Medicaid system. Behne points out MCOs get paid by the amount of denials there are, which then impacts the revenue that the medical center receives. If the hospital doesn’t receive full reimbursement from an MCO, Behne notes that they write it off as bad debt.

“We saw a decrease (in bad debt) when we expanded Medicaid in the state back in 2014-2015. Now that the MCOs are here and been in full force now for a couple of years we’ve really seen kind of a mirror image of where we are today being back to those pre-medicaid expansion numbers and I only see that climbing for here. So yeah, we just have to eat it.”

Behne adds other issues with the MCOs include having to hire three full-time employees to handle those accounts and waiting on delays when they enroll a new provider at the medical center. Behne hopes that the state legislators can look into having the MCOs be located in Iowa and put an immediate focus on lowering costs for disabled and elderly who are on Medicaid going into the next legislative session.