Continuity of Care (CoC) Risk Adjustment Program Updates
Date: 07/14/25
The CoC program aims to reward primary care providers for proactively coordinating preventive care and visits and thoroughly assessing members to improve health and clinical quality of care. Providers have an opportunity to earn added compensation by using the Appointment Agenda as a tool to guide your encounters with Iowa Total
Care members.
In January of this year, we launched the CoC+ program, which offers extra compensation opportunities for completing additional portions of the Appointment Agenda. Through its inaugural year, we’ve consulted directly with providers to gain insight on what’s working with CoC+ and where we can improve.
To ensure an elevated provider participation experience, we’re making the following updates to some
key components:
| Component | Update |
|---|---|
| Insight Sorting | Providers can now sort insights based on the added compensation amounts for the services part of the CoC+ program via our secure provider portal. A filter has been added to show only the added compensation amounts, effective June 25, 2025. Providers still have the option to see all insights if they choose. |
| Program Timeline | The CoC+ program timeline has been extended from January 1, 2025 – July 1, 2025, to December 31, 2025. |
| Medicaid and Marketplace Agendas | Non-incented Medicaid or Marketplace agendas will not be counted in the completion percentage denominator, better aligning completion rates with the CoC+ incentive structure. |
| Closed Agendas | Once an agenda is closed for reporting purposes, it will remain closed even if additional gaps are added. |
| Insight Updates | As CoC+ gaps and insights are added monthly, agendas will be honored up to 90 days prior to the date-of-agenda receipt. |
| In-home Assessments (IHA) Insights | IHA insights will only be shown if a condition is assessed during an in-home assessment and has not been addressed by the provider, effective July20, 2025. |
| Clinical Insights | Claims-based observations will be combined into one insight describing the claims history, effective July 20, 2025. |
| PDF Workflow | A one-page PDF with all gaps will be added to utilize during office visits, effective July 20, 2025. |
| Highlighting Key Members | More high-risk insights will be added, leading to a total of four high-risk gaps, effective July 20, 2025. |
For questions or concerns, contact your provider engagement account manager in your area or call Provider Services at 1-833-404-1061, Monday – Friday 7:30 a.m. to 6 p.m. CT.
Thank you for your partnership in serving our members.