It’s been a little over one year since Iowa’s privatization of medicare began.

Greene County Medical Center CEO Carl Behne says they continue to struggle to get payment from the three managed care organizations in the state.

“We have seen definitely an increase in our labor force due to the MCOs. I would guess you could equate roughly to one to one-and-a-half full time equivalent positions that we’ve had to keep fully staffed to manage the MCOs.”

The biggest problem area for the hospital is receiving payments from emergency room care. Behne notes another struggle is figuring out what services are covered under an individual’s MCO.

“So we have a family here in town that their family has all three of the MCOs and each MCO treats certain pieces of care differently, requirements are different and what’s covered and what’s not. So it is a challenge for our community.”

Behne adds that part of the unpaid claims from the MCOs are written off by the medical center as bad debt/charity care. He says the MCOs have been as much as $1 million behind on payments to the medical center. As of last month, Behne notes the total amount is about $400,00 of unpaid claims from the MCOs.

Behne points out that they regularly evaluate each MCO and determine whether or not to keep carrying each one as the privatization program moves forward.