Pursuant to the authority of Iowa Code Section 249A.4, the Iowa Department of Health and Human Services (HHS) has proposed changes to the 2021 Quality Plan. The State is required to review and update the quality strategy as needed, but no less than once every three (3) years as described in 42 CFR §438.340.
Summary
The state must draft and implement a written quality strategy for assessing and improving the quality of health care and services furnished by Managed Care Plans as described in 42 CFR §438.340. The proposed changes are summarized below:
- Utilized the CMS Quality Strategy Toolkit to assist with meeting federal requirements.
- Included HSAG recommendations to:
- Revise the Quality Strategy to include all programs supported by the MCOs and PAHPs.
- Develop overarching goals and performance objectives (i.e., quality metrics or standardized performance measures) supporting each overarching goal.
- Ensure each performance objective should follow SMART parameters (i.e., be specific, measurable, achievable, relevant, and time-bound).
- Present the Quality Strategy goals and performance objectives in a table format that also identifies whether each goal and objective apply to the MCOs, PAHPs, or both.
- Require MCOs to calculate and report on each mandatory Core Set measure or contract with its existing vendor to calculate each mandatory Core Set measure by MCO, in addition to calculating the statewide aggregate rates for each measure.
- Set MPSs or performance thresholds for HEDIS performance measures which align with HHS’ Quality Strategy goals.
- Strategic priorities are aligned across managed care plans with goals that are reflective of the work within Medicaid.
Public Review and Comments
A copy of this Quality Strategy and this public notice are posted on the HHS website at: https://hhs.iowa.gov/public-notice/2024-08-23/public-notice-public-comment-period-2024- quality-strategy. You can also find another copy of this quality strategy here: https://hhs.iowa.gov/media/14215/download?inline. 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:
Pam Lester, Iowa Medicaid, 1305 East Walnut Street, Des Moines, Iowa 50319-0114. Comments may also be sent via email to plester@dhs.state.ia.us. Please indicate “2024 Quality Strategy” in the subject line of the email.
All comments must be received by September 23, 2024 at 4:30pm.
Submitted by:
Elizabeth Matney
Iowa Medicaid Director
Iowa Department of Health & Human Services