Pursuant to the authority of Iowa Code Section 249A.4, the Iowa Department of Health and Human

Services (HHS) has proposed changes to the state plan under Medicaid State Plan

Amendment (SPA) for Chronic Condition Health Homes (IA-23-0027). The SPA is intended to terminate the current SPA.

The State of Iowa’s Medicaid program currently operates the Chronic Condition Health Home (CCHH). The proposed termination is summarized below:

Chronic Condition Health Homes (CCHH SPA IA 23-0027)

Iowa intends to terminate the Chronic Condition Health Homes State Plan Amendment (CCHH SPA) effective December 31, 2023. Alternative chronic condition care coordination models currently in place will continue to serve the population impacted by the termination of the CCHH SPA.

The reason for termination is the significant decline in participation by eligible organizations. Provider participation decreased from 24 CCHH organizations with 122 clinics in 2018 to six CCHH organizations with 11 clinics in October of 2022. Member enrollment has also declined significantly since the program moved to managed care. The last enrollment report prior to managed care was 6,898 (September 2015) compared to 969 members in October of 2022.

The State, in coordination with the Managed Care Organizations (MCOs), has developed a plan to ensure a smooth transition and continuity of care for the impacted population. Each of the MCOs will reach out to enrolled CCHH Providers in their network to discuss a transition strategy. Members will receive letters notifying them of the transition as well as a warm handoff. New member enrollments will cease November 1, 2023, with all remaining members disenrolled and transitioned to alternative care coordination services by December 31, 2023.

Fiscal Impact

The estimated decrease in Medicaid fee-for-service (FFS) expenditures for State Fiscal Year (SFY) 2024 related to the proposed changes is:

Total Dollars:  $(9,630)

Federal Dollars:  $(6,176)

State Dollars:  $(3,454)

Public Review and Comments

A copy of this SPA 23-0027 and this public notice are posted on the Iowa HHS website at: https://hhs.iowa.gov/public-notices. To reach all stakeholders, non-electronic copies will be made available for review at the HHS Field Offices.

Written comments concerning this notice, or the proposed amendments may be addressed to:

Health Home Program

Iowa Department of Health & Human Services, Iowa Medicaid

1305 East Walnut

Des Moines, Iowa 50319

Or comments may be emailed to: Healthhomes@dhs.state.ia.us. Please indicate SPA IA 23-0027 in the subject line of the email.

All comments must be received by: 9/30/2023.


Submitted by:

Elizabeth Matney

Medicaid Director

Iowa Medicaid

Iowa Department of Health & Human Services