Health Policy

Askelson Publishes AcademyHealth Blog on Iowa's 1115 Waiver

Aerial view of Iowa state capitol

Natoshia Askelson, Assistant Professor in the Department of Community and Behavioral Health, UI College of Public Health and Researcher in the PPC's Health Policy Research Program, recently published a blog on AcademyHealth's website on an evaluation of Iowa's Healthy Behavior Program (HBP) 1115 waiver, which highlighted the importance of communication and instrument testing. From the blog:

The HBP requires individuals who meet income requirements and who do not complete both a wellness exam/dental well visit and a health risk assessment to pay an income-based premium of $5 or $10 a month. Individuals with incomes at or above 101 percent of the federal poverty level (FPL) who fail to pay their premiums are at risk of being dis-enrolled. This process and outcome evaluation includes analysis of administrative claims data, yearly enrollee surveys and interviews with enrollees and clinic staff.

In designing our waiver evaluation, we anticipated that individuals with limited previous experience with the health care system and insurance would struggle with understanding how the program works. Because of this, we designed the first year of the evaluation to focus more on process and implementation, including qualitative data collections with enrollees and clinic staff. We did not anticipate the magnitude of the confusion about the program for both enrollees and clinic staff. As a result, we modified data collections to include more qualitative work and tested all interview and survey instruments extensively to ensure that we had face and content validity. 

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