Iowa Balancing Incentive Program


“The Balancing Incentive Program (BIP) is a provision of the Patient Protection and Affordable Care Act that is designed to ‘balance’ states’ spending on long term supports and services (LTSS). Iowa began participation in the BIP program in 2012 with an anticipated $61 million in enhanced Federal Medical Assistance Percentages (FMAP) for Medicaid to provide persons with greater access to home and community based services (HCBS) and reduces unnecessary reliance on institutional services. To accomplish this objective, the program has three major structural reforms for the current LTSS system: No Wrong Door (NWD): This implements specific steps to streamline access to services; Core Standardized Assessments (CSA): This [improves] efficiency, consistency and fairness in eligibility determination and assessments for LTSS; [and] Conflict-Free Case Management (CFCM): This ensures conflict-free case management throughout LTSS systems.”

State Policies & Initiatives: 
Systems-Change Funding
  • Medicaid Agencies
  • Other
  • Home and Community Based Services (HCBS)
  • Department of Human Services
Date Enacted: