The Iowa Primary Care Association (Iowa PCA) launched its value-based care efforts when Iowa expanded Medicaid coverage in 2014. The Iowa PCA created a clinically integrated network owned and managed by community health centers and the Iowa PCA to meet the unique needs of Iowa’s community health center patients. Today the network, called IowaHealth+ (IH+), includes about 80% of Iowa’s community health centers. IH+ accounts for 204,000 visits every year across 72,000 Medicaid and 4,700 Medicare Shared Savings Program members.
IH+ provides member community health centers with comprehensive technical assistance (TA), including site level clinical quality improvement and data sharing. The Iowa PCA and IH+ also use the skills and data systems of their Health Center Controlled Network (HCCN) called INConcertCare (INCC). This partnership supports the technology needed to practice value-based care. Iowa’s model ensures community health centers are in a network that understands their shared mission and recognizes the unique challenges they face.
Negotiating better contracts with Iowa’s Medicaid Managed Care Organizations (MCOs) has been a key to community health center success. “IH+ works closely with Medicaid plans to build rapport, find common ground, and establish what the partnership looks like,” said Aaron Todd, CEO of the Iowa PCA, IH+, and INCC. Pooling resources across IH+ creates negotiating leverage and streamlines contracting. With this leverage, IH+ is better able to negotiate performance goals and risk arrangements.
Moving forward, IH+ is working towards a delegated care management model with Iowa’s MCOs. This model would move care management dollars from the MCOs to health centers and allow practices to build care management teams tailored to their patients’ needs.