engebretsen-New Tactics for Building Medical Homes in Iowa
Upcoming SlideShare
Loading in...5
×
 

engebretsen-New Tactics for Building Medical Homes in Iowa

on

  • 746 views

Bery Engebretsen, MD, Medical Director, Primary Health Care, Inc. discusses Iowa's medicaid enterprise and lessons learned.

Bery Engebretsen, MD, Medical Director, Primary Health Care, Inc. discusses Iowa's medicaid enterprise and lessons learned.

Statistics

Views

Total Views
746
Views on SlideShare
589
Embed Views
157

Actions

Likes
0
Downloads
0
Comments
0

5 Embeds 157

http://www.nashp.org 147
http://www.nashpconference.org 4
http://nashp.org 4
http://webcache.googleusercontent.com 1
http://web.archive.org 1

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

 engebretsen-New Tactics for Building Medical Homes in Iowa engebretsen-New Tactics for Building Medical Homes in Iowa Presentation Transcript

  • Iowa Medicaid Enterprise 1115 waiver expansion to FQHCsPartners: Iowa Medicaid Enterprise (IME); Iowa Department of Public  Health (IDPH); Iowa/Nebraska Primary Care Association (IANEPCA)Preserved $60 mil when begun (loss of intergovernmental transfer (IGT) )Two providers: University of Iowa (U of I), local public hospital in Des  Moines.  Contributed their public $$ to preserve federal matchAll care to the U of I for entire state, thus used mostly for specialty care  (except in Polk County where public hospital was funded)Expanding to community health centers (CHCs) in step‐wise fashion with $6 millionSome political maneuvering about expansion sites and paceBegan 10/1/10 with two sites; next sites in MarchCHC funding for patient‐centered medical home (PCMH) only – not meds,  off site labSpecialty care must still go to the U of IInitial demand was huge for site near U of I
  • Defining and Recognizing• PCMH recognition required (National Committee for Quality  Assurance (NCQA) or equivalent) – “Level 1” end of 1st year – Advancing to highest level by year 2 – Fee‐for‐service (FFS) payment for visit (not cost‐based or  prospective payment system (PPS) ) – Plus $3.00 to $3.50 per member per month (PMPM) tied to PCMH  recognition, and $1 to $1.50 tied to outcomes – Annual outcomes (ten – all or none) • Colorectal, body mass index (BMI), tobacco, diabetes, adult  immunizations, Paps – Various aspects of PCMH reported quarterly • Registry reports on Diabetes • EHR progress • Patient reminders, referral tracking
  • Lessons Learned• Unmet need is huge, even in Iowa• Coordination is challenging without convenient geographic  access• Patient education is very important• Time for provider planning is important• Keep eye on the politics• Links to: – Model – Quarterly report – Annual performance report