The Iowa Department of Health and Human Services developed a workforce first mindset that has made them a national model for workforce modernization. Iowa focused time and effort on building a high-capacity team within the realities of a small staff and global workforce shortages. They prioritized internal growth, and also cross-agency collaboration and aligning staff with the needs and experience of Medicaid members.
The Workforce Challenge
Many states are facing challenges in hiring, staffing, and team capacity. Some of this is due to the national workforce challenges, while some of it is due to capped state Medicaid staffing numbers and restrictions placed on incentives for creating larger teams. Hiring staff is not the only problem states face. Retention is challenged by state employee salary caps and regulations that limit benefits. In July 2021, Iowa started off as a team of only 45 staff managing an increased enrollment of over 200,000 Medicaid members, or an increase of 30 percent. Over the past year, Iowa has found new and innovative ways to support their small staff in being highly efficient, aligned, motivated, and engaged.
In the past year, the team in Iowa developed its inaugural state strategic plan. It encompasses a mission, vision, objectives and values. All the work that the team does on a daily basis is now rooted in this plan. It took determination and skilled change management to go from focusing on the daily fires to true strategic work. Lifting up out of the weeds and maintaining a strategic view of the program and the members they serve has helped create commitment and grit amongst their staff.
In order to create lasting partnerships that improve outcomes for Medicaid members, Iowa took steps to actively build sustainable relationships with sister state agencies including child welfare, mental health authority, and the finance authority. They worked with public health partners to develop a unified maternal health strategic plan that is more actionable through appropriate delineation of expertise, authority, and implementation. Finally, the team worked to improve partnership with managed care organizations to more effectively leverage managed care flexibility to move the needle on equity and social drivers of health.
To promote a two-way communication between Medicaid staff, Medicaid members and providers, Iowa began hosting monthly town halls to tackle tough conversations and promote informed program and policy development. Iowa uses these conversations to maintain open lines of communication around eligibility redeterminations.
Finally, Iowa launched a systems modernization initiative, focused on achieving the top priority for Medicaid: improving the experience for providers and Medicaid staff in provider enrollment, screening, credentialing and maintenance of provider information. This effort is called the Medicaid Enterprise Modernization Effort (MEME).
NAMD is pleased to honor Iowa Department of Health and Human Services with the 2022 Spotlight Award. Learn more about the other 2022 Spotlight Award winners here.