Iowa Medicaid Diabetes Tel-Assurance Program
In late 2009 ICCC received funding from the federal Office for the Advancement of TeleHealth (HRSA) for the Iowa Medicaid Diabetes Tel-Assurance program. The goal of the project is to evaluate the effectiveness of telehealth strategies to improve the health of rural Iowans with diabetes who are served by the Iowa Medicaid Program. The project launched in 2010 and involves more than 200 rural Iowa Medicaid members with high risk diabetes. These members will participate in a daily telehealth survey – utilizing an interactive voice response system – to easily identify health concerns, whether symptom-based or trending in daily blood sugars. Nurse care coordinators will monitor the daily surveys and contact members who are showing “variances.”
This project focuses heavily on self-management support and patient education, although the care coordinators also refer patients to physicians when appropriate. The enrollment of Iowa Medicaid members is a cross walk between those who have a diagnosis of diabetes, those who are served in rural community health centers (CHC) and those who demonstrate high risk characteristics.
This project was funded to explore the benefits of using telehealth strategies along with traditional medical management; therefore there will be a rigorous evaluation plan. Outcomes will be evaluated in the areas of clinical improvement; quality of life; patient and provider satisfaction; cost; and healthcare utilization patterns of the participants and a matched cohort of Iowa Medicaid members who did not participate.
Primary partners for this program include: Iowa Medicaid Enterprise; Iowa/Nebraska Primary Care Association; Community Health Centers (as defined as “rural” by HRSA); Pharos Innovations, LLC; Iowa Department of Public Health (Iowa Diabetes Center); Iowa Department of Elder Affairs (Chronic Disease Self-Management Support Program); Magellan Behavioral Care; and Des Moines University (Evaluation Partner).
Pre-Medicare Health & Wellness Program
The Pre-Medicare Health and Wellness Program for Rural Iowans is a program that has been developed with the Iowa Farm Bureau Federation and funded through a grant from the Centers for Disease Control and Prevention. The program, which launched in early 2010, provides health risk assessments, biometric screening, health coaching, and an array of online health programs and trackers to participants.
The purpose of the program is to provide prevention programming and early interventions for rural residents aged 50-64 in order to improve or maintain their current health status and save in short- and long-term health care costs before they reach eligibility for Medicare. Iowa Farm Bureau Federation members in the age category of interest, and outside major population centers, were recruited in the first year of the program. Incentives are being offered to the eligible population to enroll in the program, to complete the health risk assessment and associated biometric screenings, and to be active throughout the study year with online and community programming and health coaching.
The program follows the ICCC approach to population prevention and health improvement which focuses upon achieving zero trend related to health risk and health status for engaged individuals. The unique aspect of the program is that is provided independent of a traditional employer-based wellness program.
Chronic Care Delivery Network
The ICCC has been a leader in the proposal of the Telehealth and HIT Enabled Chronic Care Delivery Network (CCDN), which was submitted to the Senate Finance Committee to be included in federal health care reform proposals. The primary objective of the proposed Network is to reduce unnecessary and avoidable hospitalization and ER visits and related costs for high-cost Medicare beneficiaries with certain chronic conditions. The Telehealth and HIT Enabled Chronic Care Delivery Network model is composed of four key modular elements:
- Chronic disease registry populated by Medicare claims data.
- Care Coordination staffing infrastructure, training, and performance management.
- Home telehealth technology for monitoring large populations efficiently.
- Care oversight by the beneficiary’s treating physician.
The four component operational model allows each of the elements to be configured at a regional or potentially local level. In other words, beneficiaries will be able to receive care through local previously established provider relationships. These providers may elect to use existing care coordinator resources (home health or office staff, for example), but will be required to undergo training and performance monitoring under a centralized network management structure. Additionally, disease registry and telehealth technologies will need to meet a prescribed standard, including HIPAA and interoperability compliance, and qualify as meeting HHS requirements for “Meaningful Use”. Finally, and importantly, a central management structure will be in place to coordinate all contracting, training, performance monitoring and quality improvement functions of the Network.
Health Risk Assessments
ICCC has worked at the community level with Ankeny Health Futures (a Harkin Wellness Grant recipient), Oakridge Neighborhood Services, and community groups in Des Moines to deploy Health Risk Assessments to a range of populations – from youth to seniors. ICCC provides consultation to community groups and others on the deployment of health risk assessments and the planning of health improvement activities for their populations. For more information on these services please contact ICCC through the contact numbers provided on this site.
