Disease Management Programs
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 will launch in 2010 and involve 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 will focus heavily on self-management support and patient education, although the care coordinators will also refer patients to physicians when appropriate. The enrollment of Iowa Medicaid members will be 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).
Congestive Heart Failure (CHF) Medicaid Study
A one-year demonstration project was conducted by ICCC, the Iowa Medicaid Enterprise, and Pharos Innovations, a technology company. The demonstration's key intervention was daily self-monitoring of weight and symptoms that provided an early warning of worsening heart failure. Participants were linked through Pharos Innovations' Tel-Assurance system, which collected the data and provided them to Iowa Medicaid nursing care coordinators in real time. The demonstration met Iowa Medicaid's objectives of improving the medical stability of chronically ill members, increasing the number of members with medical homes, reducing avoidable healthcare costs by reducing unnecessary hospitalizations, and providing a program that was well-received by participants. Using data from the Iowa Medicaid claims database, the study reported a 24% reduction in hospital admissions for the participant group, compared to a 22% increase for the control group. For more information regarding this program, read the full report.