MASON CITY | A Medicaid managed health care plan and local health care network announced Monday they have reached an agreement to maintain access to the network’s hospitals, clinics and other health care services and facilities.
In March, AmeriHealth Caritas sent a letter to the approximately 213,000 Iowa clients it serves — low-income and disabled individuals, including children — warning if the company was unable to negotiate a contract with Mercy Health Network by July 1, Mercy would no longer be included in its provider network.
The Mercy Health Network, which also has contracts with the two other Medicaid management companies that operate in Iowa, includes 13 facilities and more than 2,000 physicians and advanced practice providers in Iowa.
Locally, Mercy Medical Center-North Iowa owns or is affiliated with 43 clinics in the area, including 34 family medicine and nine specialty clinics throughout North Iowa.
For North Iowans receiving services through AmeriHealth Caritas, the closest non-Mercy medical center and family clinic is located in Charles City, according to the company’s most recent provider listings.
AmeriHealth Caritas is one of the three companies being paid by the state to administer Iowa’s $5 billion Medicaid program. The company in March said it had to renegotiate its rates to create a more sustainable Medicaid program.
The companies have reported operating losses since taking over the Medicaid program in April 2016. AmeriHealth Caritas reported losing more than $200 million in Iowa last year.
AmeriHealth Caritas says it’s “pleased to continue our relationship with Mercy Health Network,” Iowa Market President Cheryl Harding said in an emailed statement Monday afternoon.
“For more than 30 years, our family of companies has specialized in helping individuals who are most in need to access quality health care and services,” Harding said. “Mercy Health Network is a component of our efforts to build healthy communities across this state.
“We appreciate its efforts to work with us to help our members get the care they need,” Harding said.
Mercy Health Network CEO David Vellinga in the statement hailed the agreement as “great news for our patients and communities.”
“Patient care is always our No. 1 priority, and the efforts made by both organizations resulted in a continued relationship that will preserve in-network access for our patients,” Vellinga said. “We look forward to continuing our relationship with AmeriHealth Caritas and serving our patients with affordable, high quality care.”
The majority of Iowa’s Medicaid population — about 560,000 Iowans — are served through the Iowa Health Link program’s select managed care plans.