Medical Home Pilots

CoOportunity Health believes strongly in integrated care as part of the larger solution to the issues of healthcare cost, quality and access. As part of its commitment to this ideal, CoOportunity Health proposed the development of medical home pilots in its business plan submitted to the Centers for Medicare & Medicaid Services (CMS) when we applied for approval as the health insurance CO-OP for Iowa and Nebraska.

Once approved by CMS, we began to identify potential projects, seeking out provider associations and other healthcare entities that shared our commitment to patient-centered medical home (PCMH) goals and we’re working to implement initiatives with measurable outcomes.

Triple Aim

While CoOportunity Health is a young organization with limited funding resources, we are interested in partnering with and supporting organizations in Iowa and Nebraska that share our belief that transformational change is needed in order to optimize healthcare performance in the United States. We have adopted the Triple Aim* framework as core to our business practices as a health plan, but also our approach to community outreach and support. That means we are focused on initiatives that drive change in these areas:

  • Improve the health of Iowans and Nebraskans we serve
  • Improve the experience of each individual, including quality and satisfaction
  • Improve affordability through optimized performance and payment models

*Triple Aim was developed by the Institute for Healthcare Improvement (IHI) and has been adopted across the U.S. as a model for transforming the healthcare delivery model.

Medical Home Pilots

Four medical home pilots have been supported through modest grants from CoOportunity Health, to date. Best practice learnings from these pilots will be used to develop future “integrated-care-friendly” plan designs and incentive programs that will benefit CoOportunity Health members, as well as Iowa and Nebraska communities.

Contact Us: For more information about these pilots, or to learn about collaborating with CoOportunity Health, please contact Mary McConville, Leader of Integrated Care Programs, at 515.777.7057 or [email protected]

Heartland Rural Physician Alliance (HRPA)

Pilot provided seed money for member practices to achieve NCQA 2011 Patient-Centered Medical Home (PCMH) recognition. Six practices are participating in the pilot, sharing information and insight to inform the development of future payment programs. The pilot practices conducted a patient satisfaction survey prior to seeking PCMH recognition — serving as a baseline for measurement.

South East Rural Physician Alliance-Accountable Care Organization

Pilot focused on seven practices using Nebraska Medicaid Medical Home Model that establishes standards for integrated care. Baseline patient surveys and electronic health record (EHR) data were used to measure outcomes. To date, 70 providers have achieved PCHM recognition.

Iowa Association of Rural Health Clinics (IARHC)

Pilot established the Rural Health Clinic Practice Transformation Learning Collaborative to offer free support and technical assistance to rural health clinics and practices interested in achieving PCMH recognition. It features monthly interactive webinars about the challenges of implementing change for PCMH, offers a rich online toolkit of resources, and face-to-face learning sessions. Telligen and the Iowa Primary Care Association are also key supporters of the learning collaborative.

Iowa Primary Care Association (Iowa PCA)

Pilot designed to better understand, at a granular level, the needs and risks of patients at two Federally Qualified Health Centers (FQHCs). It will assist in determining how clinics that have achieved Patient-Centered Health Homes (PCHH) recognition may be paid differently than non-recognized clinics. The results of the study will be used to inform reimbursement methodologies in the future.



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