Primary Care Collaborative

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.

Primary Care Innovations and PCMH Activity

Dual Eligible	2703 SPA	CPC	CPC+	PCMH QHP	PCMH Legislation	Private Payer

Public Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
AAMC eConsults/eReferrals program - Iowa	Grant	California, Iowa, New Hampshire, Virginia, Wisconsin	CMS Health Care Innovation Award (Round 2)
Catholic Health Initiatives Value-Based Care program - Iowa	Grant		CMS Health Care Innovation Award (Round 2)
CMS State Innovation Model (SIM) Testing Award - Iowa	Grant	Statewide	CMS State Innovation Model (SIM)
Iowa Health Homes	Medicaid	Statewide	ACA Section 2703 Health Homes
Iowa Wellness Plan	Medicaid	Statewide	Medicaid Section 1115 Waiver
PTN - Iowa Healthcare Collaborative (Compass PTN)	Grant	Georgia, Kansas, Oklahoma, Iowa, Nebraska, South Dakota	Transforming Clinical Practices Initiative (TCPI)
Transitional care teams for rural patients with complex illness	Grant	Bremer, Wright, Henry, Van Buren, Benton, Jefferson, Keokuk, Marion, Washington, and Iowa counties	CMS Health Care Innovation Award (Round 1)
Trinity Health Systems - CMS Pioneer ACO	Medicare	Northwest Iowa	CMS Pioneer ACO

Private Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program	Outcomes
Wellmark Accountable Care Organizations	Commercial	Sioux City, Davenport, Ames, Cedar Rapids, Des Moines, Waterloo, Fort Dodge, Quad Cities, Iowa City, Mason City, Pella	Blue Cross Blue Shield Value-Based Care Program

State Legislation

Legislation	Status	Year
Iowa Senate File 446 This legislation authorized health care delivery and payment system reforms including the expanded use of medical homes and ACOs. The law stipulates "Any integrated care model implemented on or after July 1, 2013, that delivers health care to medical assistance program recipients shall incorporate medical homes as its foundation."	Expired	2013