A Dearth of Medicaid Home Health Data Creating Headaches for State Officials

A government official in one state is waging war on what he sees as a dearth of home health data.

Last week, Iowa Auditor Rob Sand voiced how his office could not accurately provide an analysis on certain services provided by the state’s Medicaid program, including home-based care, a local CBS affiliate reported.

Sand reportedly tried to conduct an audit and look into reimbursements for Medicaid-supported in-home care services in Iowa, but ultimately had to shift his focus elsewhere due to unreliable information and poor data.


The state auditor then detailed those frustrations in a 13-page report.

“We were, despite repeated efforts, unable to perform an analysis — an audit — of home health data because the data provided were repeatedly unreliable,” Sand told reports during a press conference.

Sand’s report argues that the data-collection process used by the Iowa Department for Human Services is “not efficient or effective.” To improve transparency into Medicaid-reimbursed home health care, the report calls for the human services department to simplify data workflows and create uniformity requirements for managed care organizations.


Doing so, according to the report, would ensure more consistent and appropriate payments in the future.

As of October 2019, roughly 18% of Iowa’s population was covered by Medicaid or adjacent services, Kaiser Family Foundation data shows. Iowa Medicaid covers roughly one in seven adults, one in two nursing home residents, one in three individuals with disabilities and one in seven Medicare beneficiaries. 

Overall, the Medicaid program in Iowa accounts for about $4.9 billion in spending, with the vast majority of that going to managed care. Long-term care, meanwhile, accounts for about 3% of all Iowa Medicaid spending.

Nationally, Medicaid pays for one in every six dollars spent throughout the U.S. health care system, according to Kaiser Family Foundation. It accounts for roughly one in two dollars spent on long-term services and supports, however.

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