Hospital leaders expressed bewilderment Wednesday at the governor’s claim that the number of Iowa Medicaid members being admitted to hospitals had dropped by more than half since private management companies began running the program a year ago.
Gov. Terry Branstad’s office made the claim in a press release trumpeting the success of his controversial decision to hire private companies to run the $4 billion Medicaid program. Branstad contends the switch, which took effect last April, is saving money by keeping members healthier. Wednesday’s press release from his office claimed that under Medicaid managed care, “hospital admissions are down 54 percent overall.”
That claim startled leaders of the Iowa Hospital Association. “We’re as perplexed as anybody. Those sort of numbers don’t make any sense,” association spokesman Scott McIntyre said Wednesday afternoon.
The hospital association, which opposed the switch to private Medicaid management, has a federal contract to collect and publish extensive data on the use of Iowa hospitals. Their data show the number of Medicaid recipients being discharged from Iowa hospitals declined about 4 percent in the past year.
The two data sets being cited aren’t exactly the same, but they shouldn’t be off by a factor of 50 percentage points, McIntyre said. He added that if the number of Medicaid inpatients had dropped more than half, hospital administrators surely would have noticed.
Amy McCoy, spokeswoman for the Iowa Department of Human Services, said the press release was based on data reported to her agency by the three national companies overseeing care for more than 500,000 poor or disabled Iowans covered by Medicaid. Those data showed a decline from 28,462 hospital admissions of those members in the three months from April through June 2016 to 13,055 from October through December. A deeper look at the numbers showed the Medicaid management companies reported that hospital admissions quadrupled last spring, from 3,905 in April to 15,664 in June, before plummeting back to 5,723 in July. The reported June spike in hospitalizations pumped up the numbers for the first quarter’s worth of data cited in the governor’s press release.
McIntyre said his association’s data shows no such spike in hospitalizations last June.
Summer months are often relatively slow times for hospital inpatient units. Dr. Patricia Quinlisk, medical director of the Iowa Department of Public Health, said Wednesday afternoon that she couldn’t think of a reason why Iowa Medicaid patients would have flocked to hospitals last June. She said that although she didn’t have detailed records at hand, “I don’t remember any big outbreak that would have caused a huge increase in hospitalizations last June.”
McCoy said her agency would double-check with the Medicaid management companies to make sure their reports were accurate.
Democratic legislators mocked Branstad’s claims. “Everything the governor lists can be refuted by patients, providers and advocates. Don’t believe this blather,” Sen. Liz Mathis, D-Robins, wrote in a press release. Mathis, the top-ranked Democrat on a committee overseeing the Department of Human Services, is a leading critic of private Medicaid management. She cites reports from patients and service providers who say the companies have added little but red tape and hassles.
The governor’s press release also cited other successes in the project’s first nine months, including 238,530 health-risk assessments and 67,284 uses of “value-added services,” such as tobacco-cessation programs. The press release also reiterates the governor’s contention that private management of Medicaid is saving Iowa taxpayers $110 million this fiscal year and will save $232 million next fiscal year. Critics have been skeptical of such figures, especially since the revelation last week that the federal and state governments could spend up to $235 million extra to help the management companies shoulder huge losses in the first year of Iowa’s privately run Medicaid program.
Jody Jenner, chief executive officer of Broadlawns Medical Center, said the number of Medicaid members receiving inpatient services at his public Des Moines hospital has dropped about 15 percent in the past year. Broadlawns, which serves many poor residents, relies more on Medicaid than most hospitals. Jenner said part of the reason for the decline in the number of inpatients served is the hospital has been unable to admit as many inpatients to its psychiatric unit, which is almost always full.