Feb. 10, 2009
Public Policy Center issues evaluation of IowaCare health plan
In its report evaluating the IowaCare health plan for uninsured adults in the state, the University of Iowa Public Policy Center found that the program is providing health care coverage for uninsured Iowans, many of whom have never had health insurance. The program was found to have met the needs of two-thirds of the previously uninsured Iowans with chronic illnesses, while the other third had problems accessing health care services.
IowaCare, a limited benefit, limited provider-network program, provides health care coverage to adults ages 19-64 whose incomes are up to twice the Federal Poverty Level, enrolling almost 30,000 people for at least one month during fiscal year 2007. Recipients must receive care at the University of Iowa Hospitals and Clinics, or the four state mental institutes, or Broadlawns Hospital for residents of Polk County. They pay no premiums or up to $75 in premiums based on income.
This report describes how Iowans use and access IowaCare, and how satisfied they are with this program serving many adults who have never had health insurance.
The Public Policy Center found that IowaCare successfully enrolled a larger than expected number of patients, especially those who have chronic illnesses. It also provided coverage to enrollees had been without any health insurance for more than two years. While IowaCare meets the needs of about two-thirds of enrollees, the other third have some problems accessing services in Iowa City and Des Moines. For example, about one-third of those outside Polk County sought urgent and routine care from a provider outside the IowaCare network because they needed to travel to University of Iowa Hospitals and Clinics for services.
"The chronic health problems of this population increase the need for prescription drugs, a noncovered service that is provided by University of Iowa Hospitals and Clinics and Broadlawns when possible. Dental care, another limited coverage service, was repeatedly said to be needed by enrollees, with oral health problems being the most frequent self-reported chronic health problem," said the authors of the report.
"IowaCare has become part of the safety net for low-income Iowans who are not eligible for Medicaid and don't have access to other insurance. The usage of this program highlights the needs of single adults and childless couples who are not eligible for Medicaid even if they have no income or resources at all," said Jennifer Vermeer, director of the Iowa Medicaid Enterprise in the Iowa Department of Human Services.
Commissioned by the Iowa Department of Human Services, the report was completed in December 2008 by the Public Policy Center and Iowa Center for Evaluation Research, a part of the National Resource Center for Family Centered Practice in the UI School of Social Work. Three methods were employed for the evaluation. Surveys were used to assess enrollee perceptions, claims data was evaluated to determine outcomes of care, and focus groups and personal interviews were conducted to assess perceptions of hospital providers and administrators.
Specific findings included:
--7,000 people re-enrolled in IowaCare after their first year of coverage.
The full evaluation report of the IowaCare program is available at http://ppc.uiowa.edu/dnn4/Default.aspx?tabid=242.