Iowa Medicaid Care Management and Lock-In Programs

Care Management: The IME program that addresses the impact that chronic diseases have on Medicaid members and the manner in which care is delivered to affected persons.  The program focuses on developing the highest quality of care, assessing the disease processes and the affect of the disease on life events.

Disease Management:  The Iowa Medicaid Disease Management program focuses on high-risk, high-cost adult and child members with multiple chronic conditions.  In Iowa, this high-risk and high-cost population represents the top 5% of Iowa Medicaid enrollment and 30% of all of Iowa’s Medicaid expenditures.

Maternity:  The Iowa Medicaid Maternity program includes a telephone outreach program for Medicaid members to provide support, education and counseling to improve health outcomes.  Women who have had previous maternity complications or medical conditions who may be at high risk with their pregnancy qualify for this program.

Lock-In: The goal of this program is to promote quality health care for Medicaid members by preventing harmful practices including:

·         Duplication of scheduled and non-scheduled medications

·         Unintended medication interactions

·         Duplication of medical services and treatments

·         Medication abuse

FORMS AND RESOURCES:

·         Iowa Medicaid Member Programs overview Oct 2011.doc

·         Lock-in Referral 470-5063 Oct 2011.doc