Mr. Randol was hired May 31. He previously led Medicaid programs in Kansas and Iowa, both of which hired private companies to administer benefits. He became the Medicaid director in Kansas in 2012, and the state privatized the system the following year. Iowa hired him in 2017, two years after the state privatized its system.
Montana is one of 11 states with an entirely government-run Medicaid system, according to the report. The state had a private managed care contract from 1993 until mid-1999. That experience was described as “problem-plagued” in a 2008 legislative report. The state has operated under a fee-for-service model since its private managed care experiment.
Rep. Mary Caferro said that she’s received many calls about Mr. Randol’s hiring from people concerned that the state may be moving to privatize its Medicaid program, according to the report. Mr. Randol said he has not had conversations with anyone about moving the state to managed care.
When asked about what opportunities he might see for managed care versus fee-for-service, Mr. Randol said every state is unique.
“If you’ve seen one Medicaid program, you’ve seen one Medicaid program. … And it really is incumbent upon the state to determine what works best for that population,” he said, according to the report. “How can you provide those services to those vulnerable members in your Medicaid program? And that’s ultimately what we need to do.”
