State Auditor Rob Sand has released a survey showing two-thirds of health care providers consider Medicaid privatization an impediment to their ability to provide services. The survey was conducted in late 2019. Nearly 83 percent of hospital administrators who responded expressed frustration with delays in getting paid by the private companies that manage care for Iowans enrolled in Medicaid.

Sand says state officials should create one system for billing, rather than letting each private company that manages care for Medicaid patients operate its own system.