Lakes Regional Healthcare President & CEO Fears Recent Medicaid Change Could Put Some Lives At Risk

Thu 10-25-2018

(Spirit Lake)-- Officials with area hospitals say they're deeply concerned over recent revisions in Iowa's Medicaid program that have changed the way they're paid for emergency room care.

Jason Harrington, President and CEO of Lakes Regional Healthcare, says one of the changes allows the two companies that operate the state's Medicaid program, Amerigroup and United Healthcare, to deny or reduce payment for hundreds of symptoms. He says that potentially could put lives at risk...Medicaid Concerns01 

"One of those diagnosis happens to be abdominal or upper abdominal pain which as a lay person you might believe that to be chest pain. What we certainly wouldn't want as a community hospital is for somebody that is actually having chest pain to feel like, that there's some obstacle for them coming to the Emergency Room to have that chest pain assessed. So there's a variety of issues that that creates both for Medicaid beneficiaries as well as hospitals and emergency room physicians. There's a lot of concern across the state about that."

In addition, officials say it will also force hospitals to absorb millions of dollars in unpaid bills. Harrington says he isn't sure just yet as to what the exact impact of that might be for Lakes Regional Healthcare but he says it shouldn't be as severe as it will be on larger facilities...Medicaid Concerns02 

"Overall in terms of our patients that we see, Medicaid makes up probably eight percent of the volumes of patients we see. So that overall impact then if you divide that further into emergency room visits, wouldn't be as significant for us as say it would be for University of Iowa or Des Moines or a larger urban center that had a higher Medicaid population, so I do not know what that exact number would be, no."

The changes went into effect in August. Health department officials told hospitals in July that the two insurers managing Medicaid in Iowa would no longer fully reimburse for emergency room care if the primary symptoms the patient initially reported turned out not be an emergency.

Privatization of Iowa's Medicaid system has become a major issue in the campaign for Governor.