What is the Iowa Aging Services Network (IASN)?
Members of LeadingAge Iowa have created a separate organization, (IASN), whose mission will be to maximize the health and well-being of seniors in its member communities through innovative, cost-effective care management practices and quality improvement activities through contracting relationships with health plans and health delivery systems so LeadingAge Iowa Network members can better serve Medicare and Medicaid enrollees. IASN will be governed by a board elected by its members and is only available to LeadingAge Iowa members.
Why do I need to work with health plans?
Skilled nursing facilities and other post-acute housing and service providers need to work more closely with health plans for the following reasons:
- Over 17 % of seniors in Iowa select a health plan that offers a Medicare Advantage product that includes coverage for skilled nursing home care (SNF-A benefits) as well as home care and other services your organization may provide. Last year, the number of Iowa Medicare beneficiaries choosing Medicare Advantage products grew by more than 20% and will likely continue to grow in the years ahead. It is important to have contracts under multiple plans so that you can serve these patients across your care continuum.
- The state of Iowa is experiencing the movement in several different Alternative Payment Models (APM) such as bundled payments for hip and knee replacements, pay for performance, ACOs and value based purchasing. These APMs will impact the way we do business as aging services providers. Coming together as a group to leverage our market presence with both payors and hospital partners will ensure our sustainability as the health care system changes.
- Health plans have expressed a strong preference to working with collaborative organizations, such as IASN, rather than with individual facilities.
What are the benefits of joining IASN?
Joining IASN will provide greater leverage in negotiating higher rates and other payment arrangements, such as pay for performance plans, with health plans. Stand alone facilities have less ability to negotiate and influence these rates and plans.
- The Network will provide educational and other resources to help your facility staff better understand how to maximize the payment components of the contracts, and to learn from other members regarding adoption of best practices and improving performance metrics.
- The Network will provide opportunities to apply for other types of innovative funding offered via the Centers for Medicare and Medicaid Innovation (CMMI), the state and other private grant opportunities.
- The Network will expand opportunities to accept more post-acute patients from hospitals as a result of contracts with multiple health plans. Health plans may be reluctant to contract with a single facility, but will be more receptive to a Network.
What services will IASN provide?
IASN has contracted with Strategic Health Care who will be responsible for contract negotiations, health systems relationships and educational resources for member facilities; credentialing and administrative support.
What will be my responsibilities as an IASN member?
- Adhere to contracts negotiated by the Network, including compliance with billing, payment and data reporting responsibilities.
- Submit necessary credentialing information required by the health plan; also meet or exceed IASN’s application requirements.
- Submit claims pursuant to health plan requirements.
- Submit cost and performance data as required by Network to promote best practices across organizations.
- Participate on Network’s board/committee structure as needed and participate in educational and training opportunities.
What is the cost of joining IASN?
The Network’s expenses have been limited to support only those activities that can directly benefit its member organization. The two tiered fee model is based on SNF member services, regardless of size, paying a flat fee of $1,000 to cover basic administrative costs, and a user fee based on a per bed/or unit costs as approved by the Board. For the first year, the annual user fee would be $75 per nursing home bed, $10 per adult day bed, $7.50 per bed for residential care facility and $5 per licensed capacity for adult day. There is no facility fee for assisted living or adult day if it is part of a continuum of care. For example, a continuum of care with 70 SNF beds, 30 assisted living beds and a 24 licensed capacity adult day would pay $6,670 in annual dues to the network.