Iowa

In June of 2013, Governor Terry Branstad signed Senate File 446 into law, which authorized health care delivery and payment system reforms including expanded use of medical homes and ACOs.

Iowa is implementing a comprehensive PCMH-based health care payment and delivery system that will reduce health care costs, improve population health and improve patient care. Iowa is transforming health care across the state through the integration of several legislative initiatives including Health Homes, Integrated Health Homes (IHH), the Balancing Incentives Payment Program (BIPP), the Iowa Health and Wellness Plan, and the Mental Health and Disability Services (MHDS) Redesign. Wellmark, the predominant private payer across the state of Iowa, is partnering with the state in its effort to implement multi-payer ACO methodology statewide. Iowa plans to implement regional ACOs for Medicaid enrollees statewide in January of 2016.

 

CHIPRA: 
No
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
3,070,800
Uninsured Population:
9%
Total Medicaid Spending FY 2013: 
$3.7 Billion 
Overweight/Obese Adults:
67%
Poor Mental Health among Adults: 
29.6%
Medicaid Expansion: 
Yes 

AAMC eConsults/eReferrals program - Iowa

The Association of American Medical Colleges received a CMS Health Care Innovation Award to fund scalability testing of an electronic consultation and referral system for implementation at five partner medical centers. The model, developed by the University of California San Francisco, aims to address gaps in primary care-specialty care communication and provide technology for non-face-to-face electronic consultation.

Wellmark Accountable Care Organizations

Wellmark is collaborating with thirteen health systems in an ACO payment system focused on improving the health care experience and slowing the rate in health care cost increases. The ACO arrangements were created to keep healthy people well and improve outcomes for our members when they need care. 

The Goals of Wellmark's ACO Strategy

Wellmark's ACO strategy will enhance Wellmark members' care in a variety of ways:

To reduce costs, health workers move toward more contact with patients

on Sun, 2014-05-11 00:00   lisabeth

The days when doctors simply waited for sick people to walk into their clinics are done. Many patients with chronic diseases now find themselves in contact with clinic-employed health coaches who nudge them to take their medications, eat right, be active and assume ownership of their health. These efforts go well beyond previous patient outreach, in part because they are increasingly tied to insurance payments. The goal is to reduce costs by rewarding providers more for keeping groups of patients well rather than simply for office visits and procedures.

Story Date: 
May 11, 2014
News Author: 
Rick Ruggles
Source Link: 
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Clinical Health Coach Training Online

The Clinical Health Coach Training Online program is designed for healthcare professionals and healthcare organizations that seek to improve the health outcomes of their patients by actively engaging them in self-management support, providing them true patient-centered care, and developing evidence based population health strategies.

Trinity Health Systems - CMS Pioneer ACO

Trinity Health Systems/TriHealth, Inc. is an integrated healthcare system located in Fort Dodge, Iowa.

Iowa Health Homes

The state of Iowa has two signed State Plan Amendments with CMS for 2703 Health Home programs. The first State Plan Amendment has a statewide coverage area and extends a medical home model of care delivery to low income adults with two or more chronic diseases or individuals with one chronic condition who are at-risk of developing a second condition.

Iowa Wellness Plan

On May 23, 2013, the Iowa Legislature enacted the “Iowa Health and Wellness Plan”. This plan is a compromise between the Governor’s Healthy Iowa Plan and Medicaid Expansion. Beginning January 1, 2014, the Iowa Health and Wellness Plan covers all Iowans age 19-64 with income up to and including 133 percent of the Federal Poverty Level. The Plan provides a comprehensive benefit package and provider network, along with important program innovations that will improve health outcomes and lower costs.

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