Evaluation of Iowa's Medicaid Managed Care Program: The Consumer Perspective

As part of the ongoing quality assurance activities of Iowa’s Medicaid Managed Care Program, the Iowa Medicaid Enterprise (IME) contracted with researchers at The University of Iowa Public Policy Center to conduct a survey of adults and parents/guardians of children enrolled in the Iowa Medicaid programs. These programs include:

1) MediPASS is the primary care case management (PCCM) model in which members have the opportunity to choose a primary care physician who acts as their primary care case manager; the identified primary care physician then approves use of specialty and emergency services,
2) The Medicaid Health Maintenance Organization (HMO), served through the Meridian Health program, works under a contract with the IME,
3) Traditional Medicaid encompassing a Fee-for-service(FFS) payment mechanism for providers, and
4) The Medicaid Supplemental Security Income Program (SSI), the program for low-income Iowans with disabilities.

Income eligible children and adults in counties with a managed care option may choose a MediPASS provider or enroll in the HMO. In counties without a managed care option, children and adults remain in the traditional Fee-for-service (FFS) program. Children and adults with a disability are enrolled into the SSI program which utilizes a fee-for-service payment model.
As of August 2014, there were 115,423 children (less than 18 years old) enrolled in MediPASS, 21,926 children enrolled in the HMO, 5,788 children enrolled in the Medicaid SSI, and there were 19,867 children enrolled in FFS, for at least 6 months with no Medicare Part A or Part B eligibility.

As of August 2014 (when the sample was drawn), there were 28,529 adults 18-64 enrolled in MediPASS; 8,060 adults ages 18-64 enrolled in the HMO; 31,407 adults 18-64 enrolled in the Medicaid SSI; and there were 8,081 adults ages 18-64 enrolled in FFS, for at least 6 months with no Medicare Part A or Part B eligibility.

Data from past years, as well as information from the CAHPS Database were used when appropriate. The CAHPS online reporting system that contains National Comparative Data2 (NCD) for the CAHPS health programs was used when appropriate.

Some results from children enrolled in Medicaid are compared the 2010 Iowa Household Health Survey (IHHS). The 2010 IHHS3 was a population-based statewide survey using a mixed-mode data collection. During the core data collection period, 2,386 parents/guardians of one randomly selected child age 0-17 years living in the household participated. The data were weighted to account for family size and post-stratified to reflect the 2010 child population in Iowa.