Iowa Health Care Quality Partners

Get better contract terms and a return on your investment – with less effort.
Network providers received $1 million in value-based payments for 2020

Access to more payers – giving you access to more potential clients and better occupancy.

• Includes more payer networks, as network health plans often prefer larger networks versus single facility contracts
• Provides better contract terms due to expertise of professional network staff

Value-based payments – giving you a return on your investment

• Offers value-based payments to participating providers and access to contracts that recognize quality and better outcomes that individual providers cannot be a part of due to volume

Administrative/credentialing support – saving you valuable staff time

• Reduces administrative costs for documentation collection and submission to multiple health plans
• Monitors contract terms and notices from payers that may try to amend contracts or require other action to stay in network

Support for claims, revenue cycle and systemic payer issues – with less hassle for you

• Identifies and solves systemic claims issues
• Reduces cost of claim issue resolution
• Provides a process and relationship with payers for escalating and resolving claims issues

Strategy and understanding – from network staff who are experts at reviewing health care contracts

• Long-term care legal expertise
• Provides expert review of contracts from network staff who understand long-term care, saving you legal fees

Exclusive education – giving you the competitive edge on quality

• Offers exclusive and specialized quality education and clinical consulting, customized to members’ specific needs

IHCQP offers you two tier options to choose from based on your organization’s specific needs.

Tier 1: Contract Support With the Messenger Model (Non-Price Terms Only)

In Tier 1, provider network members receive support to approach payers for joint contracting non-price terms. This is known as the messenger model, in which the appointed messenger (the IHCQP network) obtains information on proposed fees and fee-related terms from a payer. Then, the messenger provides that information to each of the providers separately, seeking their individual decision to accept or decline the offer.

Tier 1 services also include: 

• Credentialing
• Contract management
• Contract negotiation of non-price terms
• Payment resolution to contract
• Quality measurement and focus
• Education

Tier 2: Full-Service Contract Support With Clinical and Financially Integrated Model (Price Terms Included, Plus Quality Incentive Payout Option)

In Tier 2, network providers receive all of the benefits of Tier 1, PLUS they are able to add clinical and financial integration. This gives them the added benefits of negotiation for better contract rates and a return on their investment with a quality benchmark and investment (or quality incentive payout). This tier also includes a financial investment, quality measurement and benchmarking, implementing consistent evidence-based care paths, measuring adherence to care paths and risk sharing with MCO partners.

Tier 2 includes services provided in Tier 1, as well as:

• Quality benchmarks and investment
• Negotiation of contract rates

IHCQP has more negotiating power than other networks because it is able to communicate the quality of its network to payers. This is possible because IHCQP members measure their quality. IHCQP providers define their own set of quality measures, agree to measure, create benchmarks and aggregate existing CMS data in order to present timely, accurate quality data to payers and improve contracting options.

Examples of quality measures determined by IHCQP providers include:

• Rehospitalizations/emergency room/observation stays
• Hospitalizations following discharge from a skilled nursing facility
• Five-Star Quality Measures
  • Pressure ulcers
  • Falls with major injury
  • Immunizations

“Balancing a facility operation is a challenge. IHCQP has given us the ability to credential and negotiate contracts to be able to provide care for our consumer, with access to more insurance contracts than some small operators were previously able to attain. The network also acts as a resource by providing and hosting quality focused initiatives to not only improve care for our residents but also to achieve reimbursement outcomes commensurate with the care we provide.”

– Tom Swanson, Administrator, Maple Heights
Skilled nursing and home health care provider

“As a member of the IHCQP, I have a dedicated team of staff reviewing insurance contracts for best terms and quality incentives. I have tried to negotiate with an insurance company in the past, and due to my facility’s small number of beds and lives, it was not possible. If you are looking for a great return on investment – this is it.”

– Maureen Cahill, Administrator, Spurgeon Manor
Skilled nursing and assisted living provider

There are limited spots available. To learn more or to participate, contact Brandon Hagen, SVP, Reimbursement and Policy Advisor, at 515-978-2204.

Organizations must be a member in good standing of the Iowa Health Care Association (IHCA), Iowa Center for Assisted Living (ICAL) or Iowa Center for Home Care (ICHC) to join IHCQP.

Melessia McAninch McGinnis, MHA, LNHA, IHCQP Clinical Care Manager
mmcginnis@ahca.org

Melessia is the Clinical Care Manager for the Iowa Health Care Quality Partners network. Melessia is a licensed nursing home administrator with more than 28 years of experience as an administrator in Iowa and North Carolina. Her experience includes serving as COO for a 700-bed CCRC, an AVP and executive director for a sub-acute facility, and as an independent operator of a rural skilled nursing facility. She received her MHA in Hospital and Health Care Administration from Des Moines University.

In addition, Melessia is a CARES-certified dementia specialist, and is an adjunct faculty member at Des Moines University, teaching social gerontology and long-term care regulations.

Katie Colgan Esq., IHCQP Network Manager
kcolgan@ahca.org | 614-264-7652 (cell)

In her current position with AHCA/NCAL as Executive Director of Integrated Networks for AHCA, Katie is on the reimbursement policy & strategy team, focusing on population health management models and assisting states and providers in exploring and developing provider-owned networks. She serves as one of IHCQP’s Network Managers assisting in contracting with payers, moving to clinical integration, and ensuring network members receive increasing value from the network. In 2019 and 2020, she helped to develop the network with IHCA provider members and staff, designing a network with goals specific to Iowa, and the first of its kind for AHCA members in the country.

Prior to joining AHCA, Katie worked as a health care consultant, working with a wide array of health care providers, specializing in pre- and post-acute care, primary care and behavioral health providers, to develop managed care networks and provide managed care contracting services. Katie is an expert in value-based contracting for all types of providers, and specifically in creating new opportunities in such models and strategies for pre- and post-acute care providers. Katie also has extensive experience in public policy advocacy for providers of senior services across the long-term care continuum. She served as Vice President of Government & Payor Relations for the largest not for profit senior affordable housing provider in the country. Katie has a law degree from The Ohio State University, is licensed to practice law in Ohio, and lives in Columbus, Ohio with her husband and three boys.

Rachel Heilskov, IHCQP Clinical Care Manager
rheilskov@ahca.org | 641-494-7431 (cell)

In her role as Clinical Care Manager, Rachel will be focusing on the clinical needs and quality advancement of Iowa Health Care Quality Partners. She will be assisting network providers in reaching their quality goals both individually and collectively as a network, as the network moves to clinical integration and to be successful as the network engages in more advanced quality-based contracts. Rachel is the liaison to the IHCQP Quality Committee.

Rachel’s past experience includes 8 years of experience as a Licensed Nursing Home Administrator. Her most recent role was working for a Critical Access Hospital, where she managed the attached Long-Term Care Facility, but also assisted with Quality, Employee Engagement and Emergency Preparedness efforts for the facility as a whole. Prior to becoming an Administrator, Rachel worked as a C.N.A in Home Health, Assisted Living and Long-Term Care settings. Rachel received her Bachelor of Science in Health Science from Drake University.

Rachel lives in Hampton, Iowa with her husband and two children. She has a passion for quality and improving the lives of not only our Residents, but our Providers as well.

Akena Norman, IHCQP Credentialing Manager
anorman@ahca.org | 804-445-5164 (cell)

Akena has several years of experience working on the health payer side managing networks, contracting, credentialing, conducting audits, and writing policies and procedures for SNF-led Institutional Special Needs Plans and Dual Special Needs Plans. Akena has also worked for Medicaid managed care plan, understanding the operations of health plans from the inside out. She has experience with both Medicare Advantage and Medicaid plans on the payer side, as well as working directly with providers in building Medicare Advantage networks.

Akena lives in Tappahannock, Virginia with her husband and three kids. She has a passion for helping others and is eager to use her wealth of knowledge for the betterment of the organization.