Onboarding Background
Currently, Iowa Medicaid contracts with two managed care organizations (MCOs), Amerigroup and Iowa Total Care, to provide services for the majority of Medicaid and Hawki members. The term of Amerigroup’s contract expires in June 2023, while Iowa Total Care’s contract expires in June 2025. As a result of Amerigroup's contract expiration, in February 2022, Iowa Medicaid issued a new procurement to select the most qualified MCOs to deliver high-quality health care services for the citizens of Iowa.
Why are we onboarding this year (2023)?
In August 2022, Amerigroup was selected to continue providing services, and a new MCO, Molina Healthcare, was selected as the third MCO. Molina is expected to begin providing services on July 1, 2023. The onboarding of a new MCO takes months of preperation, training, system testing and membership assignment. The Iowa Medicaid team has worked to develop multiple initiatives, including member reassignment, to ensure a successful MCO onboarding.
Member Reassignment Goals & Logic
Member reassignment occurs when a new MCO joins the Iowa Health Link program. Members will be redistributed between the three MCOs to ensure equal membership. Members will have a chance to choose their MCO during the open choice period (March 1 through May 18).
Member reassignment within Iowa Medicaid operates with two goals:
- Maintaining continuity of care to the best extent possible.
- Equitable member reassignment to ensure all MCOs have the same membership proportion so no MCO shoulders the most critical populations.
Around 33 percent of Medicaid members will be assigned to Molina Healthcare of Iowa, 33 percent assigned to Iowa Total Care, and 33 percent assigned to Amerigroup. This means that approximately 67 percent of members will remain with their current MCO, ensuring continuity of care for most members. The redistribution logic was designed to keep family units together. Parents and siblings will be assigned to the same MCO.
Open Enrollment
All members will have the opportunity to choose an MCO during the open enrollment period, which is currently scheduled to begin March 1, 2023, and run through May 18, 2023. This includes members who were reassigned to Molina, as well as members who were not reassigned. Members should expect their open enrollment letters to arrive in mid-March.
All members will receive an open enrollment letter announcing the addition of Molina and that MCO member reassignments go into effect on July 1, 2023. Open enrollment will begin March 1, 2023, and run through May 18, 2023. After July 1, 2023, when Molina begins services, members will also be given 90 days to change MCOs.
If you would like more information about member enrollment, please visit the Choosing a Health Plan webpage.
Member Reassignment Timeline
Questions?
Please send any questions about member reassignment or the open enrollment period to the MCO Q&A Implementation inbox.