Health and Human Services awards Iowa $43 million

Staff Writer
Story City Herald

Iowa will receive up to $43.1 million to implement and test health care payment and service delivery models that will improve health care quality and lower costs, Secretary of Health and Human Services Sylvia M. Burwell announced last week.

Iowa’s plan for health system transformation builds upon the Accountable Care Organization (ACO) model that currently covers the state’s expanded Medicaid population, called the Iowa Health and Wellness Plan. This population-based model also will align with quality measures and payment methodology utilized by the Wellmark commercial ACOs. In addition, the state will work with the same data analytics contractor as Wellmark so that provider organizations have consistent and usable data to transform their practice from volume-based reimbursement to value-based reimbursement. By the end of the performance period, the Medicaid ACOs will be accountable for the long term care and behavioral health services of their attributed patients. Iowa will use funding to integrate community-based resources into the ACOs by providing technical assistance through various partners. The state also will leverage and spread existing community transformation initiatives focused on the social determinants of health.

“We are committed to partnering with Iowa to advance the goals we all share: better care, smarter spending, and, ultimately, healthier people,” said Secretary Sylvia Mathews Burwell. “We’re seeing states do some very innovative things when it comes to improving the ways we deliver care, pay providers, and distribute information. These funds will support Iowa in integrating and coordinating the many elements of health care – including Medicaid, Medicare, public health, and private health care delivery systems – to the benefit of patients, businesses, and taxpayers alike.”

Nationwide, 28 states, three territories and the District of Columbia will receive over $665 million in Affordable Care Act funding to design and test health care payment and service delivery models that will improve health care quality and lower costs. Together with awards released in early 2013, over half of states (34 states and 3 territories and the District of Columbia), representing nearly two thirds of the population are participating in comprehensive state-based innovation in health system transformation.

States will engage a broad group of stakeholders including health care providers and systems, long-term service and support providers, commercial payers, state hospital and medical associations, tribal communities and consumer advocacy organizations. Transformation efforts supported by this initiative must improve health, improve care and lower costs for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries. In addition, the Centers for Medicare & Medicaid Services (CMS) will identify best practices among state-led transformations that are potentially scalable to all states.

The State Innovation Models initiative is one part of an overall effort to help lower costs and improve care through the Affordable Care Act. Initiatives like Accountable Care Organizations, the Partnership for Patients and others have helped reduce hospital readmissions in Medicare by nearly 8 percent between 2007 and 2013 – translating into 150,000 fewer readmissions – and quality improvements have resulted in saving 50,000 lives and $12 billion in health spending from 2010 to 2013, according to preliminary estimates.

Descriptions and project data are estimates provided by the state and are based on budget submissions required by the State Innovation Models initiative application process.

For more information on the awards announced, please go to: http://innovation.cms.gov/initiatives/State-Innovations/.

To learn more about other innovative models being tested by the CMS Innovation Center, please visit: innovation.cms.gov.