DHS releases the most transparent Medicaid report in program history
(DES MOINES) - Today, Gov. Terry Branstad and Lt. Gov. Kim Reynolds commend the Iowa Department of Human Services (DHS) for releasing the second Medicaid Modernization Quarterly Report demonstrating improved patient outcomes, strong consumer protections, and robust program integrity in the first six months of Medicaid Modernization. Gov. Branstad signed every Medicaid Modernization oversight item into law from the 2015 and 2016 legislative sessions. Medicaid Modernization is delivering more accountability in our Medicaid program than ever before by tracking nearly 1,000 measurable performance and health outcomes.
“For the second time in our Medicaid program history, Iowa patients and Iowa taxpayers have the most thorough and transparent look and review of our Medicaid program. These reports help us improve Medicaid patient health,” Branstad said. “Since April 1, over 230,000 patient health risk assessments and outreach efforts were conducted identifying risk factors to a patient’s health helping them live longer, healthier lives.”
Lt. Gov. Reynolds added, “Ensuring our most vulnerable Iowans have patient-centered coordinated care is a cornerstone of Medicaid Modernization. More than 25,000 adults and children with high-risk behavioral health conditions, now have a health care coordinator assigned to them integrating their medical, physical, and behavioral health needs. This quarterly report shows progress in modernizing our mental health system.”
Medicaid Modernization is a proactive, patient-centered approach to modernizing Iowa’s old Medicaid program. Patients have more choice than ever before fitting their individual needs, more access to services, and real accountability improving the health of more than 500,000 Iowans. Medicaid Modernization has delivered unprecedented transparency and results into Medicaid.
Medicaid Modernization July - September 2016 Quarterly Report Executive Summary
The second Medicaid Modernization Quarterly Report is a comprehensive review of key metrics focused on outcome achievement, consumer protection, and program integrity.
· Patient Choice: The number of patients selecting a health plan has increased to 145,153. This is a 45% increase from the first quarter of Medicaid Modernization.
· New Benefit - Mental Health Care Coordination: Modernizing our mental health system and ensuring coordinated care is a cornerstone of Medicaid Modernization. More than 25,000 adults and children with high-risk behavioral health conditions, now have a health care coordinator assigned to them integrating their medical, physical, and behavioral health needs.
· New Benefit - Health Risk Assessments: Over 230,000 patient health risk assessments and outreach efforts were conducted in the first six months of Medicaid Modernization by the health plans. Health risk assessments were not required in the old Medicaid program. Patients identifying risk factors to their health and making corrections help them live longer, healthier lives.
· New Benefit – Value-Added Services: Over 40,000 value-added services in this quarter were utilized. The health plans offer numerous value-added services that go above and beyond what traditional Medicaid benefits offer. These value-added services are intended for the right patient to improve their health and well-being including health incentives, tobacco cessation, and wellness programs.
· Patients Receive Timely Helpline Services: When patients have questions they can contact the health plans’ member helpline. All three health plans exceeded the timeliness requirements required by their contract. Also, the state conducts “secret shopper calls” to ensure quality of those helpline services.
· Home and Community Based Services (HCBS) Waitlist Drops: DHS tracks HCBS for patients who receive services in the community instead of an institutional setting. Since April 1, 2016 the HCBS waitlist has seen a reduction of 2,200. This means more patients are getting HCBS services and in a more timely manner.
· Health Plans Exceed Claims Requirements: All three health plans exceeded the contractual expectation that 90% of payment claims be paid within 14 days. Old Medicaid never had an expectation for payment claims. The average payment claim under Medicaid Modernization is paid under 9 days. This is consistent with the old Medicaid program paying an average of 7-10 days.
· Increased Value-Based Purchasing Agreements: The health plans have more than doubled their value-based purchasing agreements. The health care field is shifting from volume-based services to value-based services ensuring patient-centered care. Our health plans took significant steps forward in this second quarter of reporting to lead the way in the patient-center value-based health care environment.
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