In Iowa, almost 95 percent of the Medicaid population is covered by a Managed Care Plan (MCP). Iowa uses two different types of MCPs to deliver medical and dental benefits. One type, Managed Care Organizations (MCOs) like Amerigroup, Iowa Total Care, and Molina Healthcare, provide members with their health and long-term support and service (LTSS) benefits. The second type, Prepaid Ambulatory Health Plans (PAHPs) like Delta Dental of Iowa or Managed Care of North America (MCNA) provide members with their dental benefits.
Populations not covered by MCPs are provided coverage through the state's Fee-for-Service (FFS) program.
Performance monitoring and data analysis are critical components in assessing how well the managed care plans (MCPs) are maintaining and improving the quality of care delivered to members. Pursuant to House File 2460, Division XXII, Section 93(4), the Department of Health and Human Services (HHS) is to submit a Medicaid Managed Care Oversight Report annually.
Performance monitoring and data analysis are critical components in assessing how well the managed care plans (MCPs) are maintaining and improving the quality of care delivered to members. The quarterly reports, with a number of elements required through oversight legislation, are comprehensive and focus on compliance areas, as well as health outcomes over time. The department examines the data from a compliance perspective and conducts further analysis if any issues are identified. While there are specific performance standards in the contract for a limited set of items, not all data reported is directly linked to a contractual requirement. Items which do have contractual requirements are indicated in the reports.
Performance monitoring and data analysis are critical components in assessing how well the managed care plans (MCPs) are maintaining and improving the quality of care delivered to members. The monthly data reports are a snapshot of information on major contract compliance areas and member enrollment. The department examines the data from a compliance perspective and conducts further analysis if any issues are identified.
The managed care plans (MCPs) must demonstrate access within the contractual requirements or additional network adequacy standards developed by Iowa Medicaid. The Managed Care Network Geographic Access reporting looks at MCP provider networks in order to assess member access and network capacity.
The Department of Health and Human Services (HHS) has created an infographic to share certain enrollment numbers, costs and quality outcomes of the Medicaid program in an easy to understand format. The Medicaid infographic is published annually.
Mental Health Parity Report
The Iowa Department of Health and Human Services (HHS) has published this report to comply with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The Medicaid Parity Rule applies the MHPAEA to Medicaid and is intended to create consistency between commercial and Medicaid markets. The purpose of this report is to comply with the requirements for the state to provide assurance of compliance with parity requirements to the Centers for Medicare and Medicaid Services (CMS), to ensure compliance with delivery systems via state guidance and review of deliverables, to implement any needed changes, to monitor for continued compliance, and to post documentation of parity compliance on agency website.
The Medicaid Statistical Report is a summary by county report that shows eligibles, recipients served, and total payments for three categories - Total Medically Needy, Total All Other Medicaid, and Grand Total. It also has a total for each county grouped by regions.
This report presents the results of a study of how Iowa Medicaid members in four populations rated Medicaid, on a variety of measures, during 2014. The surveyed populations include the Adult Social Security Income (SSI), Adult Non-SSI, Child SSI, and Child Non-SSI. The report also shows a comparison between the SSI and non-SSI populations.
Public Reporting Measures
The Iowa Medicaid Enterprise Public Reporting Measures share enrollment, demographic, and budget information in relation to Iowa Medicaid members and programs.
Quality performance measures seek to measure the degree to which evidence-based treatment guidelines are followed, where indicated, and assess the results of care.
