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The State of Iowa has changed its Medicaid programs as a result of the AHRQ-supported Medicaid Care Management Learning Network. Through AHRQ's Knowledge Transfer Program, the Learning Network has had significant impact on the Iowa State program in the area of its provider engagement strategy. The Learning Network serves State Medicaid agencies that operate care management programs for chronically ill beneficiaries in fee-for-service plans or primary care case management programs. The Iowa Medicaid program is one of 17 States participating in this Learning Network.

The Learning Network provides expertise to participating States in four key areas critical to ensuring a quality-driven care management program:

• Helping patients become active in their care.
• Encouraging provider participation in care management programs.
• Creating program interventions aligned with the State's measurement strategy that will impact patient care.
• Designing valid and reliable evaluations to determine program success.

Iowa's care management program began in July 2005 and now covers members with asthma, diabetes, and congestive heart failure, as well as members with high utilization and high costs. The Iowa Foundation for Medical Care operates the program as part of a larger contract with Iowa Medicaid. Services provided to members include a call center, telephone care management, educational materials, and a tele-assurance program. A tele-assurance program is a phone-based system that employs interactive voice response technology to contact members.

After hearing discussions and presentations at ÂÜÀòÊÓƵLearning Network Workshops about the importance of having a systematic way to get provider input on a State's care management program, Iowa Medicaid staff moved forward with several steps. They also established relationships with leaders from physician groups, the public health community, and other provider organizations.

As one way to build such relationships, Iowa Medicaid officials decided to implement a Clinical Advisory Committee (CAC), after hearing a Learning Network presentation on North Carolina's CAC. Iowa staff consulted with North Carolina representatives before creating its committee of nine physicians who represent different geographic areas of the State.

Provider advisory groups like the CAC provide several important functions to a Medicaid agency and a care management program. Through the CAC, Iowa is able to gain the important perspective of physicians on Medicaid policies and to obtain the buy-in of those physicians on policies they see and approve. The CAC has discussed and reviewed provider and member engagement strategies, Iowa's electronic medical record system, member educational materials, and methods for incorporating depression screenings into care management.

Iowa Medicaid continued its outreach efforts to obtain provider input by meeting with the Iowa Primary Care Association and the Iowa Academy of Family Physicians. In addition, Tom Kline, DO, the Iowa Medicaid Medical Director, met with three staff members from the Iowa Department of Public Health to promote a partnership between the Iowa public health community and Iowa Medicaid. Kline has attributed Iowa's increased efforts to engage providers to the Learning Network and the lessons he has learned through Iowa's participation.