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:

  1. No Wrong Door (NWD)
    This implements specific steps to streamline access to services

  2. Core Standardized Assessments (CSA)
    This improves efficiency, consistency and fairness in eligibility determination and assessments for LTSS

  3. Conflict-Free Case Management (CFCM)
    This ensures conflict-free case management throughout LTSS systems
News and Announcements
  • Balancing Incentive Program (BIP) Core Standardized Assessment (CSA) Implementation of SIS-C® Assessment for Children: Effective March 2016, the SIS-C will be used to assess children ages 5-16 years served through the Intellectual Disability Waiver and ICF/IDs. The SIS standardized assessment was selected for this program as the functional assessment to determine if an applicant meets the level of care criteria for waiver enrollment. The assessment will also be used as a service planning tool to assist in identifying the supports and services members need to live successfully in the community. Read Informatinal Letter 1616 for more information.

Information Resources