UIHA Signs ACO Agreement With Medicaid

Program will encourage healthy behaviors for Iowans

(DES MOINES, Iowa) - The State of Iowa has signed agreements with two large accountable care organizations (ACOs) to encourage healthy behaviors and improve health outcomes for thousands of Iowans covered by the Iowa Health and Wellness Plan.

ACOs are groups of doctors, hospitals, and other health care providers, who have agreed to provide integrated care to patients. The goal is to achieve better health results for Iowans, as well as foster accountability in their care.

Under these agreements, health care providers assume financial risk to deliver high‐quality outcomes of a defined patient population - in this case, Iowa Wellness Plan members.

The two major entities, University of Iowa Health Alliance LLC and UnityPoint Health Partners, have signed up to be accountable for the Iowa Wellness Plan population effective April 1, 2014. The State of Iowa is engaged in discussions with other providers who may sign up soon.

“This is an exciting step in helping Iowans complete healthy behaviors,” said IME Director Jennifer Vermeer. “By coordinating care for Wellness Plan members, we are working to ensure that patients get the right care at the right time, with the goal of spending health care dollars wisely and with better outcomes.” The State of Iowa has aligned its ACO approach with Iowa’s major commercial health insurance payor, Wellmark Blue Cross and Blue Shield. This spreads value-based reimbursements across payors, allowing providers to make achievable, sustainable changes. In addition, the federal Medicare program currently operates ACOs in Iowa, further aligning
new payment strategies.

ACOs are incentivized by quality bonuses that align with the Iowa Health and Wellness Plan’s Healthy Behaviors program. Under that program, members’ monthly contributions are waived if they complete a risk assessment and annual physical. If the activities are completed in 2014, the monthly contributions would be waived in 2015.

To date, more than 84,000 individuals have signed up for the Iowa Health and Wellness Plan.  Of those enrolled, more than 17,000 have a primary care provider affiliated with either the University of Iowa Health Alliance LLC or UnityPoint Health Partners.

The ACOs:

  • University of Iowa Health Alliance LLC is comprised of health systems, county hospitals, RHCs, and Federally Qualified Health Centers across Iowa and include systems like, Genesis Health System, Mercy Health Network, and the University of Iowa Health System.
  • UnityPoint Health Partners is comprised of UnityPoint Clinic, Trimark Physicians Group (Fort Dodge), Central Iowa Hospital Corporation (Blank Children's) and St. Luke's Health Resources (Sioux City).

For more information
Amy Lorentzen McCoy

University of Iowa Health Alliance