Newest Medicaid problem--Mayo Clinic has not signed contracts with Iowa's managed-care companies

The State of Iowa shifts to private management of its $4 billion Medicaid program on Friday, April 1st.

The change comes as Mayo Clinic Health System officials say they have decided not to sign contracts with any of the three managed care firms that will supervise Iowa's new system.  That will have significant impact in the Decorah area, as well as in other communities near the Minnesota border--or the borders of Wisconsin, Illinois, Missouri, Nebraska or South Dakota.

State of Iowa officials say last year 5,800 Iowa Medicaid patients used Mayo Clinic services in Rochester.  The change also will affect Medicare patients from Iowa who have Medicaid as secondary insurance.  If they continue to receive services in Rochester, they would have sharply higher out-of-pocket expenses.

Decorah physician Dr. David Heine says he's worried about another change that will start April 1st.  Under the private management system, Medicaid patients in northern Iowa who wanted to avoid having higher out-of-pocket expenses would face longer trips to see a new specialist.  Says Heine, "Many of these patients will now need to travel to Iowa City or Waterloo for care, which may be a significant hardship for some."