Phase 1 (Complete):
Introductory phase—identified data sources and analyzed the financial and organizational structures of the safety net providers in Iowa, and conducted a literature review. The National Advisory Committee (NAC), and State-Level Leadership and Advisory Groups were selected.
Phase 2 (Complete):
Following the preliminary data collection and consultation with the advisory committees, three subcommittees were established:
- Primary care safety net provider-FQHCs/RHCs
- Primary care safety net payer-Medicaid
- Primary care safety net service-Oral health
Phase 3 (Complete):
Additional funding and technical assistance was obtained to support the activities of the subcommittees including a grant from the Dentaquest Foundation, and a technical assistance award from the National Academy for State Health Policy (NASHP) and a contract with the Iowa Department of Public Health to explore consumer and business attitudes
Phase 4 (Complete):
Inventory reports for the 5 safety net providers, 5 safety net payers, oral health, public health programs and the uninsured were compiled, detailing the revenue, expenditures, patient populations and utilization of services. The safety net provider reports also included a legal analysis compiling and summarizing all of the language in the Affordable Care Act pertaining to each provider.
Policy Briefs—five policy briefs are being developed from the background research and data collection:
- Attitudes of consumers entering the Health Insurance Marketplace and the health status of those most needing coverage
- Financing of the safety net and revenue projections for FQHCs
- Capacity for services at FQHCs and RHCs
- Community care team development in era of ACOs
- Oral health safety net-public and private capacity
Strategy development—the Steering Committee and University of Iowa Public Policy Center staff will draft a set of potential strategies for improved integration and coordination within the safety net including the development of community care teams and health homes. An iterative process will be used to incorporate feedback from the NAC and State Leadership and Advisory Group members on an ongoing basis. Subcommittees will also be utilized to delve more deeply into the implications of strategies for particular types of safety net providers (e.g., FQHCs) or particular types of services (e.g., oral health) that may be particularly affected by the anticipated changes.