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:
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