Current Projects

The Comprehensive Wellness Assessment Project with Iowa Medicaid

ICCC is partnering with the State of Iowa to improve the health status and reduce the future health risks of Iowa Medicaid participants by engaging them in a Comprehensive Wellness Assessment soon after they enroll in Medicaid.

The Comprehensive Wellness Assessment consists of three components:

  • The Health Risk Appraisal (HRA)
  • The Well Health Medical Exam
  • The Health Action Plan (HAP)

Together, these three components provide a motivational environment by which the member can be educated about their current health status, and begin to self-manage health risk areas. The Health Action Plan will allow them to focus on priority risk factors, and offer further support through referrals to the Health Care Initiatives program. The data gathered by the HRA provides a proactive tool to identify targeted members who would benefit from being directed to one of the planned Health Care Initiatives.

The HRA is designed as a valued added tool or strategy providing benefits as detailed below. Each of these benefits has a distinct outcome orientation.

  • Provides personalized evidence based health recommendations which prompt and promote individual health responsibility.
  • Provides aggregate population descriptive and health data upon which other programs can be planned and smartly targeted. Examples: risk management data such as smoking, weight, etc.; chronic disease risk stratification; and, potential for personal change.
  • Provides evidence based information to physicians and other health care professionals to be used as the basis for a personal health action plan.
  • Provides health risk and status data, at points in time, to authenticate the value of program interventions for the population.
  • Improves the capacity to build and operate the Iowa Medicaid program as a "smart" health plan.

he deployment of the Comprehensive Wellness Assessment assists the Iowa Medicaid program to meet another important goal--that of identifying a medical home for each participant. The combination of taking the HRA, completing the well health medical exam and receiving an individualized health action plan encourages the development of a trusting patient-physician relationship.

Iowa Medicaid Population Disease Management Demonstration

ICCC has been awarded a grant from the Office for the Advancement of Telehealth (OAT) to conduct a population disease management project serving Iowa Medicaid patients with a primary or secondary diagnosis of congestive heart failure. It is anticipated that the project will now run through March 2007.

Additionally the program is expected to:

  • Improve access to effective, accessible health care and health improvement strategies to Iowans in both rural and urban locations
  • Develop approaches to manage chronic care with a disadvantaged population through collaboration with physician networks and state associations
  • To improve capability at the state level to accurately plan appropriate programs and predict cost.

Total project budget includes $294,619 OAT funding and $155,875 funding from other sources for a total project budget of $450,494.

Ankeny Healthy Futures (Community-Based Pilot Project)

ICCC has been meeting with the Healthy Ankeny Futures Network, a group spearheaded by Ankeny Community Schools Community Education, which received a Harkin Wellness Grant last fall. The group plans to provide a free personal health assessment to 400 individuals to get baseline data on the overall health of the community. After assessing the needs of the community learned through the aggregate data collected from the PHAs, community wellness programs will be developed to help meet those needs.

ICCC, with PDHI, will assist in providing the initial 400 PHAs and hopes to expand beyond that number in corporate sites, churches, schools, and medical clinics. This project is considered a community-based pilot for ICCC as part of its program plans for using health risk assessments as a basis for assessing risk and assisting with chronic disease management program planning and implementation.

Healthy Living Clubs (Population-Specific Pilot Project)

ICCC has been developing a program concept called Healthy Living Clubs. The related program involves an initial assessment of health status and risk for chronic conditions (PHA) subsequent "Healthy Living Club" education around the "Ten Pillars of Successful Aging" and follow-up annual Personal Health Assessments (PHA) over time. The program would be developed with affinity groups such as faith based organizations, neighborhood associations, employers, or selected statewide organizations. Much like investment clubs or Weight Watchers, the character of group support and competition would be employed. The target population would be 50+ year old individuals. The relationship with affinity groups would add to the sustainability of the developed enterprise. The Consortium has been working with Dr. Robert Bender, a gerontologist, with Iowa Health System to develop the concept. This project is considered a population-specific-based pilot for ICCC as part of its program plans for using health risk assessments as a basis for assessing risk and assisting with chronic disease management program planning and implementation.

Recently Completed Projects

^ Top

Federal Diabetes & CHF Demonstrations

ICCC recently completed an 18 month demonstration project in the care management of patients with congestive heart failure and diabetes, as supported through a federal earmark and administered through the Office for the Advancement of Telehealth (OAT).

Mercy Health Network and Iowa Health System each deployed different telehealth strategies in the care management of enrolled patients. There were 780 unique patients served by the CHF programs and 47 served by the diabetes programs. In addition, another 224 patients were served using the home health monitoring equipment in a palliative care program that was not included as part of the OAT grant.

Clinically, cumulative results of this demonstration indicated decreases for IP hospitalization of 64% and ER visits of 61% for MHN and 31% and 24% for IHS. Functionality improved and the cost of care was decreased. These measures indicate more stable patients whose quality of life has improved through participation in the programs.

Iowa Disease Management Feasibility Study

ICCC was engaged in exploring a population-based disease management project for four hospitals in southeast Iowa. Building upon an existing administrative structure for a regional renal dialysis program, chief goals for this project involved the development of a centrally coordinated disease management program, with localized follow-up of care management needs.

The following project milestones were completed as a planning process for the feasibility study.

  • A core leadership group, representing all S.E. Iowa Hospital CEO's and physician leaders, was organized, and a planning meeting was facilitated by ICCC.
  • A clinical leadership meeting, representing all hospitals, was facilitated by ICCC.
  • Comprehensive reference materials on Disease Management best practices were supplied to all four hospitals.
  • Potential vendors, to assist in management of high risk patients, were interviewed, with input from the S.E. Iowa clinical leadership group.
  • A formal business proposal, as written by ICCC, but with direct input from members of the S.E. Iowa Leadership team, was completed.

In December 2005, ICCC learned that the hospital CEOs determined that this project would not be easily feasible for continuation. Reasons included, changes (i.e. reduction) in health care utilization patterns, and a low readiness factor for the deployment of disease management. Several hospitals indicated that they were facing significant challenges in other areas of business, and did not have the time to focus on a disease management program. They were also unsure of the long term options for reimbursement of such services.

The business plan for this project will remain timely for the future, and ICCC has voiced willingness to work with the hospitals, should the environment and interest toward Disease Management change. In addition, the plan is transportable to any rural location, should other Iowa hospitals wish to engage in a similar project.

Future Projects

^ Top

Oakridge Neighborhood Services

Oakridge Neighborhood Services of Des Moines, with support from ICCC, submitted a grant application to Mid-Iowa Health Foundation for assistance in providing personal health assessments to their population. The goal of this program is to develop a baseline of health risks associated with those served by Oakridge and to further develop a plan to address chronic disease prevention and management in this population.

The grant has been received and Oakridge is currently formulating a plan for deployment. Oakridge will contract with ICCC to provide PHAs and to the approximately 1,000 individuals—adults and children--served by Oakridge. ICCC will also assist in the identification and possible coordination of interventions needed for the Oakridge population based on the aggregate data provided from the PHAs.

Youth HRA

As part of its program plans for using health risk assessments as a basis for assessing risk for chronic disease, the ICCC has entered into partnership with PDHI to develop and deploy an HRA for youth ages 0-18. Unlike the adult HRA, where the market offers several online, as well as paper-based HRAs, there appear to be no online HRAs available for youth, and limited paper-based assessments. Within the project opportunities for ICCC, several community-based organizations, as well as the Iowa Department of Public Health have voiced an interest in learning more about the health risks of children in Iowa. Of chief focus is the increasing incidence of obesity, unhealthy eating habits, sedentary lifestyle and Type II Diabetes among children.

To date, the youth HRA is now partially built and deployed. The age 6-12 version is being used in the Modeling Wellness for Youth project, a grant –funded project involving the Iowa Farm Bureau Federation, the Wellness Council of Iowa, and ISEBA schools. 379 second and third grade children are eligible to take the HRA within this project, and results will be used to build a comprehensive school-based wellness initiative in the participating schools.

The adolescent version (ages 13-18), is researched and roughly specified. The version I of this age group will be built when there is a target client and project for its use. Once slotted into PDHI's operations schedule, it would take 6-10 weeks to complete and deploy this version.

ICCC has also supported the development of the Youth HRA by providing up front development funding of $45,000. This action was approved at the June 10, 2005 ICCC Board of Director's meeting. In return, once deployed, ICCC will receive a portion of the HRA revenues.

Improving the Health Status of Rural Iowans Through Prevention

ICCC and the Iowa Farm Bureau are partnering on a three-year statewide initiative to provide preventative health programs for select rural Iowa residents aged 55-64 who are at risk for chronic illness. The project will provide a health risk assessment to approximately 30,000 Farm Bureau members and provide data to the individual and in aggregate form on the health risks of rural Iowa residents. Based on the results of the HRA data, approximately 1,000 of those who complete the HRA will be targeted for prevention initiatives, disease management, and/or health coaching. ICCC and Farm Bureau will work with many partners to provide a variety of resources and concentrated health management programs to at-risk individuals.