DES MOINES – Governor Terry Branstad says Medicaid patients are getting better access to care and health outcomes.
This week, Gov. Terry Branstad and Lt. Gov. Kim Reynolds highlighted Medicaid modernization success stories connecting patients with services to live healthier, happier lives. Medicaid patients are getting access to better care, seeing greater flexibility to deliver that care, and ultimately better health outcomes under Medicaid Modernization.
Below are examples of what they call “positive Medicaid patient experiences” from the first several weeks of Medicaid Modernization:
Success Story #1: Transportation (Amerigroup Iowa, Inc.)
A member in southwest Iowa who struggles with bi-polar disorder and other complex medical needs expressed that she had previous issues with non-emergency medical transportation before the new program began. She called Amerigroup to ensure she would be able to access transportation, and to talk about concerns related to an upcoming surgery. Amerigroup representatives ensured that her transportation appointments were logged, and she knew who to call if she had any questions or concerns. Once the member’s transportation needs were addressed, Amerigroup also helped this member with her post hospital discharge care. Through a program called Mom’s Meals, the member receives meals delivered to her home, allowing her to focus on recovery after surgery.
Success Story #2: Pharmacy Co-Pay (Amerigroup Iowa, Inc.)
Amerigroup received a call from a member who wanted to verify benefits after reading in her member handbook that there is no co-pay for her medication. Under the old Medicaid program, the member had to pay $15 for each prescription she filled. The member was very grateful not to have co-pays, and explained she was on a fixed income and that every penny counted. She said she could use the amount she would have paid in co-pays to help buy groceries.
Success Story #3: Heart Disease and COPD (AmeriHealth Caritas Iowa, Inc.)
The AmeriHealth Caritas integrated health care management team reached out to a member with multiple co-morbid conditions including severe cardiovascular disease, multiple heart attacks, congestive heart failure and chronic obstructive pulmonary disease. A care manager worked with the member to complete a health assessment and work to monitor blood pressure at home. They also discussed the member’s health care goals. The care manager began working with the member on a care plan and provided the member with information on how to quit smoking and arrange transportation to the member’s medical appointments. The member was appreciative of AmeriHealth Caritas’ care coordination efforts and was receptive to further education, resources and follow-ups.
Success Story #4: Bright Start (AmeriHealth Caritas Iowa, Inc.)
A Bright Start (prenatal and neonatal care management program) care manager received a prior authorization request to have specialized in-home nursing care for an infant born extremely premature that was about to be discharged. The care manager worked quickly to review and approve the service so the member didn’t have to worry over the weekend. The AmeriHealth Caritas care manager quickly contacted the provider to inform them of the approval and start the process of scheduling the nursing care.
Success Story #5: Language Line (United Healthcare Plan of the River Valley, Inc.)
A Spanish-speaking family with two children with complex care needs used the Language Line as they met with a United Healthcare employee. The employee used the line to make sure she could best help the family to overcome language barriers and understand their new health coverage. Through the Language Line, a trained and certified interpreter was able to review the changes that have taken place with the Medicaid program and introduce the family to United Healthcare. The employee and family reviewed waiver services and other services the children are able to receive through the IA Health Link program. The family was very pleased and decided to switch to the United Healthcare employee for their case management services.
