The newly published Wisconsin Family Care IRIS 2.0 Concept Paper merely describes additional steps to achieve the cherished (MCO) Managed Care Organizations well known business model goals. Federal and State Government through the Wisconsin Department of Health Services named the MCO's and further authorized the operation to administer a fund maintained for a pre-defined set of services.
The MCO's strive to meet the well known objectives:
- Care for people where they live
- Consistent service set available every where
- Technological individual record designed to prevent duplication
With the cooperation of the Federal and State Government the Wisconsin Department of Health Services using a legislative waiver will re-name the MCO's and add to the duties for the purpose of achieving the above listed objectives.
The next name to replace the MCO's Managed Care Organizations will be IHA's Integrated Health Agencies. This top down upgrade will require much more of the Integrated Health Agencies than the MCO's were expected to do.
For Starters:
- IHA's must be Wisconsin Licensed Insurance Companies
- IHA's must have more money in risk reserve
- IHA's must administer the program in larger geographical areas
- IHA's must effectively manage many more diverse services
This can mean existing MCO's may transition their business to perform the service rather than administer the program. Do not be surprised if an existing MCO announces plans to operate as a premier home care agency. The once MCO would then contract with the operating IHA to provide home care for eligible Family Care IRIS 2.0 beneficiaries.
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