Healthy Behaviors Incentive Program
On January 1, 2014, Iowa implemented the Iowa Health and Wellness Plan (IHAWP). IHAWP expands coverage for low income Iowans through two new programs: the Marketplace Choice and the Wellness Plan.
The Wellness Plan provides coverage for adults aged 19-64 years with income up to and including 100 percent of the Federal Poverty Level (FPL). 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 aged 19-64 years 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.
IHAWP replaces the IowaCare program with plans that cover more services, offer a broader provider network, and expand coverage to other low income adults in Iowa who were not previously enrolled in IowaCare.
As a part of both the Wellness Plan and the Marketplace Choice Plan, enrollees are encouraged to participate in a Healthy Behaviors Incentive (HBI) program involving three components: 1) a wellness exam and health risk assessment (HRA), 2) provider incentives, and 3) healthy behaviors. This program is designed to:
* Empower members to make healthy behavior changes.
* Establish future members’ healthy behaviors and rewards.
* Begin to integrate HRA data with providers for clinical decisions at or near the point of care.
* Encourage members to take specific proactive steps in managing their own health and provide educational support.
* Encourage providers to engage members in completion of the healthy behaviors by offering incentive payments.