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State of Iowa
Medicaid Transformation Grant Application
Iowa Medicaid Health Connections Program
Iowa Department of Human Services
Iowa Medicaid Enterprise
Eugene I. Gessow
State Medicaid Director
Iowa Department of Human Services
(515) 725-1121
(515) 725-1010 (Fax)
egessow@dhs.state.ia.us
ABSTRACT
IOWA MEDICAID HEALTH CONNECTIONS PROGRAM
Responding to the escalating cost of health care and an increased emphasis on personal
responsibility for one’s health, the Iowa Medicaid Enterprise* is planning an enterprising
strategy that focuses on the prevention of disease as a method of reducing cost, improving
quality and improving the health status of Medicaid members.
Preventable illnesses comprise 70% of the total burden of disease in the U.S. It is further
recognized that chronic conditions can be prevented, managed, and postponed through early
detection and adoption of healthy behaviors. Participation in preventative screenings, such as
mammograms and cervical cancer screenings, are significantly lower within Iowa Medicaid than
reported nationally for Medicaid, Medicare or commercial health plans.
Iowa Medicaid is currently launching the Comprehensive Wellness Assessment Program
(CWA) for targeted members. The CWA is comprised of a health risk assessment, a physical
exam by a health care provider and a personalized health action plan provided to the member by
their physician. While the program will be offered at no charge to the Medicaid member, and
incentives will be provided to members who participate, it is recognized that barriers exist in
engaging members and providers to participate in this voluntary program.
To increase participation in both preventative screenings and the CWA program, Iowa
Medicaid is seeks support for Health Connections—a program to create an infrastructure and
decision support system that regularly and routinely prompts Medicaid members to access
preventative screenings and assessments, gain knowledge about their health and wellness
(through the CWA program) and use that knowledge as the base for developing a continuum of
care, from establishing a medical home to building confidence in self care. Through the CWA
program, Medicaid members will be assisted in establishing a medical home where they can
receive more consistent, cost-efficient and evidence-based preventative care and health
maintenance monitoring from specially- trained Medicaid providers.
Funds received through a CMS Transformation Grant will support development of an
outreach campaign, a specialized call center, and professional training programs for providers
focusing on tools that can assist them in delivering evidence-based preventative health
recommendations within their clinical settings. Services will be provided through the
cooperative efforts of Iowa Medicaid, county public health departments, Medicaid service
providers and two statewide, non-profit health care collaboratives.
Health Connections plans to engage at least 15,230 eligible adult Iowa Medicaid
members (or an additional 14% of the eligible population) per year in preventative screenings
and participation in the CWA program. All 38,000 Medicaid providers will have access to a
web-based provider training program and regional conferences. County public health
departments will be actively engaged in working at the local level to facilitate the CWA program
with Medicaid members, and offer assistance and resources to members as needed.
Overall cost/benefit will be evaluated based on industry projected ROI, inclusive of the
cost to operate the program. The business model will be similar to that of current commercial
health plans. The total budget request for this proposal is $2,768,452.
* The Iowa Department of Human Services is the single state agency charged with the administration of the Medicaid program.
The Department has developed the Iowa Medicaid Enterprise to effectively manage the operations of the Medicaid program.
Any reference to either contained in this proposal necessarily includes the other.
Project Narrative
Problem Statement/Program Need (15 points): Describe the project, discuss why it is
needed, and describe the innovation of the project.
Responding to escalating costs and consumer demand for quality and safety, a shift in
focus from acute care to prevention of disease is evidenced by strategic initiatives in commercial
and government-funded health plans. More health plans are placing the consumer at the center
of focus for change, as the primary agent of their own health, and providing them with tools to
increase their ability to make informed choices among their health care options or alter their
health behaviors. For example, Medicare is in process of initiating a Senior Risk Reduction
Demonstration, commercial health plans such as Blue Cross Blue Shield have instituted multi-
million-dollar wellness campaigns for members, and in states such as Oregon, Medicaid health
plans serving large populations are screening all new members to identify those in need of care
management.1
The Iowa Medicaid Enterprise (IME) is currently in process of launching the
Comprehensive Wellness Assessment (CWA), a program to positively impact the health of its
members and reduce avoidable health care costs. The CWA will provide each Medicaid member
a facilitated online health risk assessment, a physical exam and an evidence-based preventative
health action plan in a stepwise comprehensive program coordinated by the member’s provider.
Although progressive for a Medicaid population approach, this voluntary program seeks a
strategy for engaging the Medicaid provider and empowering the Medicaid member to become
an active partner in his/her own health care and a responsible health care consumer.
To address this need, Iowa Medicaid is proposing Health Connections, a systems
approach to preventative care for Medicaid members, with the CWA as an integral component.
1
Health Supports for Consumers with Chronic Conditions, Center for Health Care Strategies, February 2005
Iowa 1 Health Connections
Health Connections will create a system that regularly and routinely prompts Medicaid
members to access preventative screenings and assessments, gain knowledge about their
health and wellness, and use that knowledge as the base for building a continuum of care--
from establishing a “medical home” to building confidence in self care. A medical home
provides the regular and routine care received from a trusted physician/provider who works with
patients to identify and access the medical services needed to help them achieve their maximum
potential. An important outcome of this project will be shifting health care utilization from
costly emergency and acute care to more cost-efficient preventative and health maintenance care.
Health Connections will actively link the member to the CWA program as part of a
system that establishes access to a medical home and health provider who will deliver evidence-
based preventative health recommendations and encourages the completion of screenings that are
recommended by the U.S. Services Preventative Task Force. Engaging members is expected to
be a greater challenge in the Medicaid population due to changes in eligibility, frequent address
changes, and, potentially, lack of a consistent method of contact such as telephones.
Quarterly review of Iowa Medicaid claims data will identify members that have not
participated in preventative screenings as recommended. Eligible members who do not respond
to an initial outreach campaign will receive 3-5 contact attempts by a call center. The call center
will transfer the list of members who agree to participate in screenings and/or the CWA to their
county public health departments, located in all 99 Iowa counties, for local follow-up, facilitation
and physician appointments. Careful attention will be given to cultural and health literacy.
Recommended Screenings
Iowa 2 Health Connections
The Health Connections program will focus on increasing utilization by Medicaid
members of six essential preventative screenings2 that target the leading causes of death and
disease to Iowans (see chart).
Screening Tool Recommended Age and Test Related Disease
Frequency
Mammogram Every 1-2 years for women 40 Breast Cancer
and older
Pap Smear Women who have been sexually Cervical Cancer
active and have a cervix
Ages 18-64
Colonoscopy Age 50 and every Colon Cancer
10 years
Blood Pressure Every 1-2 years for persons 18-64 Heart Disease and Stroke
Congestive Heart Failure
Cholesterol, HDL Age 20 for those with other risk Cardiovascular Disease
Cholesterol, LDL Cholesterol factors for coronary disease) Stroke
Triglycerides Otherwise, men 35 and older Diabetes
women 45 and older
Blood Sugar Every year for men and women Diabetes
Preventative screenings are an important step in identifying chronic conditions at their
earliest and most treatable stages. As illustrated below, Medicaid members are currently
participating in at least two preventative screenings at a much lower rate than members of
commercial health plans or the Medicare population.4
Breast Cancer Screening Cervical Cancer Screening
Year Medicaid Medicaid Commercial Medicare Medicaid Medicaid Commercial
(Iowa) (National) (Iowa) 3 (National) (Iowa) (National) (Iowa)
2004 NA 54.1% 85% Ave. 74.0% NA 64.7% 86%
2005 33.43% 53.9% 70.7% 71.6% 25% 65% 73.8%
Barriers to Participation
Preventative screenings and the CWA program are a covered service, without additional
co-pay, to members of the Iowa Medicaid program. Despite this incentive, challenges with
2
The Guide to Clinical Preventive Services 2005: Agency for Healthcare Research and Quality
3
Average of Wellmark Blue Cross and Blue Shield and John Deere Health
4
HEDIS, National Committee for Quality Assurance, 2004-2005
Iowa 3 Health Connections
transportation, access to providers, language barriers, and health literacy issues are anticipated as
barriers. Iowa currently has limited data to substantiate assumptions on why preventative
screenings are currently underutilized. This limitation is not unique to Iowa Medicaid as
commercial health plans in Iowa are also focused on identifying the root cause barriers and
motivational strategies to increase participation in selective preventative health screenings to
90% and above.5
Provider Engagement
Provider education and support are crucial to increasing the percentage of Medicaid
patients who receive evidence-based preventative health screenings and recommended treatment.
According to a recent RAND study, even when chronic conditions are diagnosed Americans
receive, on average, only about 55% of care that is suggested by established medical standards,
regardless of type of health care coverage.6 Health Connections will deploy an extensive
provider training program to familiarize Medicaid providers with Health Connections activities,
as well as the components of the Comprehensive Wellness Assessment. County public health
offices will serve as the primary facilitators in assisting members to complete the health risk
assessment portion of the CWA, and to access a provider for their preventative screenings,
physicals and personal health action plans.
Health Connections is an innovative strategy for increasing the effectiveness and
reducing the escalating cost of health care by focusing on prevention to avoid the onset or
mitigate the progression of disease. The program provides critical missing links in the
continuum of care that will empower Medicaid members and engage Medicaid providers.
5
Dale Andringa, M.D., Medical Director of Wellmark Blue Cross & Blue Shield, interview on 9/12/06
Bruce Steffens, M.D., Medical Director of United Healthcare, interview on 9/21/06
6
Redefining Health Care: Creating Value-Based Competition on Results, Harvard Business School
Iowa 4 Health Connections
Project Justification (15 points): Describe how the Medicaid program that will be
demonstrated by the project will cause/contribute to improving the effectiveness and efficiency
of the State’s Medicaid program.
Preventable illnesses make up approximately 70 percent of the total burden of disease in
the U.S. (as measured in terms of premature deaths and potential years of life lost) and their
associated costs.7 The cost of treating chronic conditions places a heavy burden on the Iowa
Medicaid program. In 2005, the total cost of caring for members with diabetes, a relatively small
percentage of the Medicaid population, was over $72 million.8 The prevention of chronic
conditions, in contrast to acute care treatment, is comparatively inexpensive and proven
effective. Several studies have documented the benefits of prevention programs, and in worksite
locations the return on investment (ROI) for wellness initiatives varies from $1.81- $6.15 per
dollar invested.9 Yet preventive health services that can bring the greatest return on investment
have delivery rates of 50 percent or lower for the general population.10
There are currently 36,800 providers enrolled in the Iowa Medicaid Program. In the
current health care environment, provider clinical practices are primarily focused on acute and
emergent symptoms. Health Connections promotes a shift in practice and delivery patterns for
the office visit. The use of preventative screenings and the Comprehensive Wellness Assessment
programs will provide a prevention and health maintenance plan for patients to ensure the best
outcomes.
Project Goals and Outcomes (15 points): Describe the goals and anticipated
outcomes/impact of the project. If applicable, also describe the technology that will be used
and if it adheres to accepted industry standards.
7
DHHS, 1991
8
Iowa Department of Human Services, 2006
9
www.pophealth.wis.edu/uwphi/publications/briefs/vol6%20No.5.pdf
10
Johnson, Dineley, “Preventive Services a good investment for health,” Nation’s Health, 00280496, Aug 2006,
Vol. 36, Issue 6
Iowa 5 Health Connections
Goals
1. Increase the number and percentage of Iowa Medicaid members who participate in
six priority preventative screenings.
2. Enroll Iowa Medicaid members in the established Comprehensive Wellness
Assessment program as primary path to access preventative screenings.
3. Increase the number of members who have an established medical home.
4. Educate and support Medicaid providers in delivering evidence-based preventative
health strategies to Medicaid members.
5. Identify root causes and barriers to member utilization of preventative screenings.
Anticipated Outcomes/Impact
1. Medicaid members will be informed as to the value/benefit of screenings.
2. Medicaid members will know how to access prevention screenings.
3. Medicaid providers will be engaged and proactive in recommending prevention
screenings and utilizing the CWA program.
4. Medicaid members have a medical home—a physician/provider whom they know and
trust and utilize for preventative care and acute care.
5. Avoidable healthcare costs are reduced, due to prevention program and established
new system member enrollment in preventative screenings.
6. Member satisfaction with Iowa Medicaid program increases as members are able to
improve or maintain their health status.
7. Members knowledge of and ability for self-management of behaviors, health status,
and health risks is enhanced.
8. Root causes and barriers to accessing screenings experienced by Iowa Medicaid
members are identified and mitigated, as appropriate.
9. Medicaid members are referred as appropriate to Iowa Medicaid Care Management
programs.
10. Iowa Medicaid program will have data on aggregate health status and risk on their
member population for decision making.
11. Aggregate member quality of life (QALY) will increase.11
This project will employ state-of-the-art technology in two areas:
1) The online components of the Comprehensive Wellness Assessment include the health
risk assessment (HRA) and the personalized health action plan. The HRA is a scalable, data-
driven assessment for total population health management and is part of a data system that is
responsive to individual responses (branching logic). It provides a customized health action plan
based on the recommendations (findings) from the HRA and biometric data (total cholesterol,
11
QALY is the measure used to define the disease, injury and premature death that would be prevented if the service
were delivered at recommended intervals over the life that the service is recommended.
Iowa 6 Health Connections
LDL cholesterol, HDL cholesterol, triglycerides, VLDL cholesterol, and blood glucose as well as
height, weight, and blood pressure) from associated laboratory results. The health action plan is
pre-populated with best practice guidelines (based on the patient’s health needs) and will trigger
decision support in the areas of further preventative testing or treatment recommendations with
evidence-based data.
2) A specialized call center that will be used to contact and engage targeted members, to
document trends in adherence to preventative health screenings and barriers to participation, and
to administer participant follow-up
Estimates of Impact to Beneficiaries (15 points): Describe the projected number of
individuals who will be directly affected by the project, and clearly define the project target
area.
The Health Connections program seeks to engage at least 15,230 adult Iowa Medicaid
members statewide, out of a total of eligible population of 109,931, in preventative screenings.
This is an additional 14% per year. Data from 2004-05 reveals that between 25-33% of eligible
members are currently participating in selected prevention screenings.12 The goal of Health
Connections is to elevate the percentage of members screened to 40% in cervical cancer
screenings and 50% in breast cancer screenings in the first year.
The benefits gained through preventative efforts and resultant ROI in the Medicaid
program may be even greater than for the general population. In FY05, Medicaid program
expenditures of over $2 billion represented 15% of Iowa’s total state budget. An average
hospitalization cost the Medicaid program $10,939.13 Through Health Connections, it is
anticipated that hospitalizations will be reduced, primarily due to the establishment of the
medical home and early identification of risk factors and symptoms.
12
Department of Human Services, September 2006
13
Profiles, 2005, Iowa Hospital Association
Iowa 7 Health Connections
Description of Magnitude of the Transformation and System Change (15 points): Describe
the size and scope of the project in terms of transforming the current Medicaid system, and
discuss the potential for replication of the project in other States.
Health Connections incorporates recommendations made from the landmark report of the
Institute of Medicine (IOM), which identifies gaps in quality of care and recognizes the need to
reorganize physician practices to better support the care of those with chronic conditions.14 Iowa
Medicaid will support physicians in providing preventative health visits to its members by
reimbursing for these services and providing incentives for physicians who complete the health
action plan of the CWA program.
Health Connections seeks to transform the Iowa Medicaid program into a high quality
health plan organization by reporting health trends and preventative health outcomes for the
population that it serves. Organizations that rigorously report outcomes have higher
accountability for providing quality care, and following well-established care guidelines.15 The
technologies that will capture meaningful data are the health risk assessments and the use of the
call center. Each has a data system that is accessible to the Iowa Medicaid program for
aggregate health data and reporting trends. Compiling, evaluating and reporting data, especially
over time, will increase the quality of care that members receive from Medicaid providers.
With 36,800 Medicaid-approved providers statewide, Health Connections will seize the
opportunity to create significant health system change. To reach providers with the appropriate
education in a peer-to-peer structure, the program will partner with the Iowa Healthcare
Collaborative (IHC), a provider-led, quality-improvement-focused organization that has a unique
role in accelerating clinical improvement in Iowa. This program provides a tremendous
opportunity for the Iowa Medicaid program to be a leading health plan in supporting a culture
14
Priority Areas for National Action: Transforming Health Care Quality, Institute of Medicine of the National
Academies, The National Academies Press, Washington, D.C., 2003
15
“The State of health Care Quality 2006” National Committee for Quality Assurance, Washington, D.C.
Iowa 8 Health Connections
shift in clinical care, assuring that prevention and health promotion are part of every health care
encounter. The IHC will create a web-based learning tool-kit for this project, allowing
physicians and allied health providers to learn more about recommended preventative screenings,
evidence-based preventative patient teaching (including an emphasis on health literacy), methods
of engaging the Medicaid population more effectively, and utilizing the targeted screenings as an
opportunity to prepare for reporting their practice outcomes.
Through Health Connections, the Iowa Medicaid program will invest resources in
preventative health, which, over time, will demonstrate cost reduction to the Medicaid program,
and improved member health status. Members, CMS, Iowa Medicaid, the State of Iowa and
taxpayers at all levels will join in the resulting benefit.
Health Connections employs a variety of proven strategies and tools such as targeted
mailings, call center, local follow up, physician referral, health risk assessments and health
outcomes reporting that have been replicated in a variety of regional, commercial, and
governmental populations. The active combination of such strategies supports the potential for
replication in other state Medicaid programs.
Description of the sustainability of the project (15 points): Describe the State’s plan to
sustain the project after the grant funding is exhausted.
The sustainability of Health Connections will be validated by its performance in reducing
avoidable health care costs and improving the quality and longevity of life for Iowa Medicaid
members. The Iowa Medicaid Enterprise will test the sustainability of Health Connections on
both business case (life years saved and projected return on investment) and quality
improvement measures.
Increasing the number of Iowa Medicaid participants who both participate in preventative
screenings, and receive evidence-based health recommendations will improve the population
Iowa 9 Health Connections
health outcomes of the Medicaid program. To the extent that the program increases the numbers
of members participating in prevention screenings, the program will demonstrate success.
Increasing participation in screens results in early diagnosis of otherwise silent diseases such as
cervical cancer, high blood pressure and high cholesterol.
Finally, the sustainability of the project will determined from a business case model. To
determine the project’s return on investment, it is recognized that Health Connections will have
costs beyond the costs of screenings. Overall cost/benefit will be evaluated based on industry
projected ROI, inclusive of the cost to operate the program. The total budget request for this
proposal is $2,768,452. Industry average for prevention program cost is $60-$130 per
participant16. This project is proposing to impact 30,466 individuals over two years, which
brings the cost to an average of $98 per person. Upon evaluation of the impact of the projected
ROI, and quality improvement, the program will be considered for inclusion into the Iowa
Medicaid State Plan in FY09.
Evaluation Plan (15 points): Describe the evaluation plan of the project (at a minimum, the
State needs to ensure compliance with the statutory reporting requirements of the new section
1903 (z)(3)(C)(ii) & (iii) of the act).
The primary goal of Health Connections is to increase the number of Iowa Medicaid
members who participate in preventative screenings and the CWA program. Identifying eligible
members for those screenings, educating members regarding the value of those screenings, and
facilitating their access to and use of those screenings comprise the activities essential to
program success.
The National Resource Center for Family Centered Practice at the University of Iowa
will provide a comprehensive evaluation for Health Connections. The evaluation will ensure
that the requirements of the annual report are met including assessment of the quality
16
“Mining Health Risk Assessments for Richer ROI and Results,” The Healthcare Intelligence network, 2006
Iowa 10 Health Connections
improvements and clinical outcomes and estimates of cost savings resulting from the
transformation grant. Experienced evaluators will conduct an objective evaluation which will
document planning and implementation of the project, identifying factors that contribute to the
success of the project. Routine feedback from the evaluation will function to monitor progress
being made and better inform decision-making with respect to the implementation. The plan for
conducting the formative and summative evaluation includes a Year 1 review documenting roles,
personnel for the implementation, commitment of funds and materials while the Year 2
evaluation focuses on the status of each component of the project assessing the progress and
improvements to the system and estimates of resulting cost savings to the Medicaid system.
The evaluation will employ a mixed methods approach to documenting the
implementation of the project including the data from staff observations, meeting minutes,
records and reports, interviews, and instruments and measures developed which to provide data
over time. The focus of the formative evaluation will be process and summative evaluation will
look at implementation and outcomes, and how effectively the project achieved the stated results.
The use of mixed methods and triangulation of findings ensures validity of the results. The
methods proposed address process questions such as: Was the web-based training protocol
effective? The summative evaluation will address the extent to which goals were met and
outcomes were achieved. For example, were objectives met and what facilitating factors or
barriers were there? What improved health outcomes can be documented and how has the
increase in provider knowledge improved health outcomes for Medicaid members? In what
measurable ways are Medicaid members benefiting from the program process? What is the
return on investment? Do measures indicate increased member utilization of preventative
screenings, participation in the CWA program, benefits of preventive screening to the
Iowa 11 Health Connections
participating members, physician engagement, and cost avoidance based on the increased
number of preventive screenings. A health economist will be employed to analyze and assess
anticipated results from the outset.
Description of the Project Implementation Readiness (15 points): Describe the State’s
ability and plan for implementation of the project. The description should include
implementation tasks/timeline with milestones and status.
IME will contract with the Iowa Chronic Care Consortium (ICCC), an Iowa-based
preventative health and disease management organization, to provide administrative project
management for this program. The ICCC is a non-profit, 501(c)3 corporation, with a mission to
improve health and productivity for all Iowans through access to proactive chronic care
strategies that are regular, routine and reimbursed. The ICCC will work in partnership with IME
to develop the program and integrate program components with existing IME resources, as
appropriate. See Figure 2 for Project Organization outline.
The nature of this project is largely the deployment of program activities that are rapidly
operational. The CWA program will be operational by November 2006. The call center will be
contracted, with target patient engagement goals at approximately 5,500 calls per month. The
Iowa Healthcare Collaborative (IHC) will develop web-based provider training programs that are
easily and conveniently accessible by all Medicaid providers. The IHC will also coordinate
Iowa 12 Health Connections
regional conferences on the prevention and treatment of chronic diseases during the second year
of the project.
Project TimeLine and Milestones
Year 1 Year 2
Activity Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Responsible
Party
Contractual Agreements X IME
signed-- IME and ICCC
All data and sub-contract X ICCC
Agreements signed
Assign project coordinator X IME
Hire Project staff-ICCC ICCC
Data Base developed/ X X X X X X X X IME
updated and provided to
Call Center for all eligible
Medicaid members that
have not completed
targeted screenings
Development/distribution X X X X X ICCC
of mailers for outreach IME
campaign
Call Center Activities X X X X X X X Call Center
(Member engagement,
Referrals to county health
departments
Statewide trainings to X X X ICCC and
county health departments Public Health
regarding facilitation of Departments
HRAs and partnering with
physician offices to
schedule wellness exams
and clinical lab tests.
Development of Web- X X IHC
based provider training
modules
Development of Provider X X IHC
Tool-kit CD
Statewide conference on X X IHC
Chronic Care (held in ICCC
several regions)
Project Evaluation X X University of
Iowa
Iowa 13 Health Connections
Health Connections Project Budget (30 points) – FY 2007- FY2008
Item Expense Detail CMS CMS Description of Budget Item Expense
Number Category FY07 FY08 Type
1 IME Project TBA $ 107,200 $107,200 Project Coordinator at IME will coordinate all aspects of the Personnel
Coordinator 100 % S&B for 24 months Health Connections program including goals, outcomes, budget, IME
$80,000 + 34% S&B deployment, contracts along with ICCC and other contractors.
2 IME Medical Dr. Thomas Kline $ 30,000 $ 30,000 Medical Director for program. Will work with ICCC and the Iowa Personnel
Director $2,500 per month for 24 Health Care Collaborative (IHC) to plan and coordinate Iowa IME
months Medicaid Provider trainings. Will work with ICCC and IHC to
complete evaluation of online education, regional conferences, and
clinical results. Will assist with data requests required for the
design and conduct of the Health Connections project.
3 ICCC Project Dr. William Appelgate $ 48,000 $ 48,000 Will act as administrative liaison between IME, ICCC and other Contractual
Administrator $4,000 per month for 24 collaborating organizations. Will direct the operations of the ICCC
months overall project.
4 ICCC Project TBA $117,920 $117,920 Will direct the technical and operational aspects among program, Contractual
Director 100% S&B for 24 months including the call center, Iowa Health Care Collaborative, county ICCC
$88,000 +34% S&B public health departments, etc. Will complete required reports and
communications related to the Health Connections project.
5 ICCC Clerical TBA $ 24,120 $ 24,120 Provide support to Project Administrator and Project Director and Contractual
Support 50% S&B for 24 months coordinate communications among all contractors. ICCC
$36,000 + 34% S&B
6 ICCC Call Center will provide an $596,970 $596,970 Will complete live out bound calls to members to promote Contractual
Center estimated 64,680 outbound awareness to value, facilitate access, identify and mitigate barriers ICCC
calls per year to Medicaid and connect with county public health departments. Will include
members to complete system design, training and data reporting.
preventative screens and
accept estimated 1,650 Will field inbound calls to facilitate scheduling by county public
inbound calls as follow-up health departments for preventative screenings and CWA program
to mailings. Estimated at
$9.00 per call for training,
system, operations, calls,
and data system reporting
7 Evaluation Design, conduct, analysis $ 67,141 $ 64,691 National Resource Center for Family Centered Practice will Contractual
and reporting of the project conduct the evaluation of the Health Connections program to University
at 5% of the total project include the annual report, assessment of quality improvements, of Iowa
budget clinical outcomes, and estimates of cost avoidance or cost savings
from the program.
Iowa 14 Health Connections
8 IHC Training & $100,000 in first year will $100,000 $ 75,000 Iowa Healthcare Collaborative will develop a statewide Contractual
Deployment include development provider training program and toolkit. Will assist providers IHC
work; second year at to become familiar with and utilize the Health Connections
$75,000 for maintenance program, the preventative screenings, the CWA program
and training and evidence-based recommendations in delivering
effective preventative health recommendations. IHC will
coordinate regional conferences as well as develop and
deploy an on-line training program for physicians and other
health care providers regarding screenings, CWA program,
HAP, process, incentives and reporting.
9 Telecommunica- $300 per month for 24 $ 3,600 $ 3,600 Local and long distance phone, FAX, and computing Contractual
tions & Phone months support recognizing no overhead in the project budget. ICCC
10 Final Report & $ 5,000 Production and dissemination of the final report; Contractual
Dissemination preparation, printing and distribution of 1,200 copies. ICCC
11 Program Awareness flyer/postcards $100,000 $85,000 Will include design and distribution of mailings, reminders, Contractual
Marketing and to all eligible members and educational materials to targeted Iowa Medicaid ICCC
Outreach @1.10 per mailer both members, making them aware of their eligibility for
years. Development of screenings, CWA program, incentives and the benefits of
mailers, outreach participation. Communications to physicians and health
materials to providers and care providers and to the county public health departments.
to members, and postage
12 Follow-Up $10.00 per follow-up, $152,000 $152,000 Completed by the county public health departments, these Contractual
Surveys anticipating 15,233 surveys will assess the level of satisfaction of participants ICCC
follow-ups per year who have completed preventative health screenings and the County
CWA program. It will provide follow-up contact to Public
determine ongoing needs of this population in building Health
relationship with physicians and confidence in self- Offices
managing lifestyle behaviors to maximize positive health.
13 Supplies & $ 5,000 $ 5,000 Office supplies, copying and materials. Contractual
Copying ICCC
14 Accounting, $ 40,000 $30,000 Fee paid for financial, legal, and compliance oversight plus Contractual
Management & the development of contracts and Business Associate ICCC
Legal Agreements between all entities including IME, ICCC, IHC,
call center, and others.
15 Project $ 18,000 $14,000 Travel for statewide coordination of program, planning and Contractual
Meetings, deployment meetings with call center and Iowa Medicaid ICCC
Travel, Training representatives, and mandatory project meetings.
FY Totals FY1 FY2
$1,409,951 $1,358,501
Grand Total $2,768,452
Iowa 15 Health Connections
