Healthy Behaviors Claims-Based Report #3 and HRA Completion Report

Wright, B.; Momany, E.; Askelson, N.; Bentler, S.; Ahrens, M.; Damiano, P.
06/2021

Abstract

On January 1, 2014 Iowa implemented the Iowa Health and Wellness Plan (IHAWP). IHAWP expands cover- age 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 have access to the Medicaid provider network established for this program.

Marketplace Choice provided coverage for adults aged 19-64 years with income from 101-133 percent of the Federal Poverty Level (FPL). Marketplace Choice allows members to choose certain commercial health plans available on the health insurance marketplace, with Medicaid paying the member’s com- mercial health plan premiums. Due to the absence of a qualified health plan, the Marketplace Choice plan was phased out and members were transitioned to the Wellness Plan as of January 1, 2016.

IHAWP replaces the IowaCare program with plans that cover more services, offer a broader provider net- work, and expand coverage to other low-income adults in Iowa who were not previously enrolled in Io- waCare.

The Marketplace Choice Plan ended on January 1, 2016, and all of these members were transitioned to the Wellness Plan. Then, starting April 1, 2016, all Wellness Plan members were enrolled into Medicaid managed care.

A component of IHAWP called the Healthy Behavior Incentive (HBI) Program, encourages members to complete several healthy behaviors in an attempt to encourage prevention and reduce longer term costs. Members are incentivized to complete a wellness exam (annual physical or dental exam) and a health risk assessment (HRA), in exchange for having their monthly $5 or $10 premium waived. This evaluation report provides updated completion rates for wellness exams, HRAs, and/or both activities among IHAWP during the first three years of the program (CY 2014 – 2016). Because of program changes over time (e.g., theelimination of the Marketplace Choice Plan and the transition to managed care), we do not report separate results for Wellness Plan and Marketplace Choice members. Instead, we assign individuals to a lower-in- come group (<100% FPL) and a higher-income group (101 – 133% FPL), because we can do this in all years, and analyses of program compliance by income level remain meaningful.

Citation

Wright B, Momany E, Askelson N, Bentler S, Ahrens M, Damiano P. Healthy Behaviors Claims-Based Report #3 and HRA Completion Report . Iowa City, IA: University of Iowa Publc Policy Center; 2021.