On January 1, 2014, Iowa implemented the Iowa Health and Wellness Plan (IHAWP), Iowa’s version of the Medicaid Expansion allowed under the Affordable Care Act. IHAWP expands coverage for low income Iowans through two new programs: The Iowa Marketplace Choice and the Iowa Wellness Plan. The Iowa Wellness Plan provides coverage for adults ages 19-64 with income up to and including 100 percent of the Federal Poverty Level. It is administered by the Iowa Medicaid Enterprise (IME). Members will have access to the Medicaid provider network established for this program. The Marketplace Choice Plan provides coverage for adults 19-64 with income from 101-133 percent of the Federal Poverty Level (FPL). The Marketplace Choice Plan allows members to choose certain commercial health plans available on the health insurance marketplace, with Medicaid paying the member's commercial health plan premiums.
The PPC will be evaluating both the Wellness Plan and the Marketplace Choice Plan by examining outcome, cost, and performance measures and the experiences of both the IHAWP enrollees and providers. Many facets of the program will be examined over the course of the evaluation:
- Outcomes of care, such as inpatient and outpatient utilization of services will be analyzed using the enrollment, claims, and encounter data for the enrollees of each plan.
- Program costs will be evaluated by calculating the PMPM costs for enrollees and conducting cost effectiveness analyses by combining the costs of care with quality and access to care indicators to determine not only potential cost-savings but whether or not the plan provided better value for each dollar spent.
- Enrollee perceptions of care and satisfaction with their experience in the IHAWP will be evaluated using mailed and online surveys.
- Evaluation of the provider network for the IHAWP will be conducted by generating maps to examine geographic variation in provider availability. In addition, provider perceptions of their experience in the IHAWP will be examined using qualitative interviews and focus groups.
A first look at Iowa’s Medicaid Expansion, the IHAWP, is included in the report “First Look at Iowa’s Medicaid Expansion: How Well Did Members Transition to the Iowa Health and Wellness Plan from IowaCare.” This report is included below and provides the results of a survey of IowaCare members who transitioned into the IHAWP and summarizes their initial experiences as new members of the IHAWP.
To read about the Iowa Dental Wellness Plan Evaluation, click here.