Letter To The Editor: “I have never seen it this bad.”

Editors Note: The views and opinions expressed in this editorial are not necessarily the views or opinions of Oskaloosa News.

I am Cheryl Plank, the Executive Director at Tenco, Industries. Tenco has been around for over 50 years. We provide services in a 10-county region in South Central Iowa.  We have offices in 7 counties with our main office in Ottumwa.  We employ 230 people across this region and currently serve over 300 individuals with varying abilities.

Although I may understand the reasoning for bringing managed care into Iowa and overall there may not be any issues with this for the medical community, I don’t understand trying to squeeze services for people with disabilities into it. Of the 39 states that have Managed Care, only 2 include the population with disabilities– Iowa and Kansas.

Thirty-seven states chose not to include this population due to the individuals’ nonmedical needs. The services I am referring to are different, they are not based on a medical need. I am referring to the services we provide at Tenco, some are 24/7 care and may be from birth to death. Residential care, in home skill building, employment services, respite, and day habilitation services that are outside the traditional healthcare arena.

Since Managed Care began in April of 2016, we have seen a decline in services to those in need as well as a decline in reimbursement for the services provided – with no reduction in expenses.

Many agencies like Tenco chose to work with AmeriHealth Caritas in the beginning because they seemed to truly care about our services and the individuals we work with. They were willing to negotiate and work with clients and providers.

They left because they claimed they were losing too much money.

Now most everyone was moved to United Healthcare (UHC) beginning December 1st and because of the payment structure with them we are seeing another decrease in funds, if we were getting paid at all. Unfortunately, at the writing of this letter, after our first full month of billing, we have only been paid for 22% of our monthly billing. Much of our billing has been denied payment due to various denial reasons.

They are reporting also that there appears to be a glitch in the system. They are working on it but in the mean time we just don’t get paid.

In my 30 years in the field I have experienced the volatility of the funding. I have never seen it this bad. I ask you, how does a business survive such a system?  How long can providers like us continue to do the work with no pay.

No money no mission!

I want you to be aware there is a bill out – SF 2013 – that would take LTSS (disability services) out of Managed Care and put it back in the state system.

Posted by on Jan 28 2018. Filed under Editorial. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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