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In 2010, the 128th Ohio General Assembly unanimously enacted Substitute House Bill 198, establishing a patient-centered medical home (PCMH) education advisory group tasked with implementing and administering a PCMH education pilot project. The first phase (planning and practice selection) of the pilot is complete, and the advisory group is now seeking funds to implement the program. The pilot includes 44 practices affiliated with four specific medical schools or five specific nursing schools, seven of which are led by nurse practitioners (exceeding the statutory requirement of four). While reviewing applications for participation, the advisory group was required to consider the percentage of a practice’s patients who are part of a medically underserved population, including Medicaid recipients.

Additionally, the advisory group will work with all medical and nursing schools in the state to develop new medical home curricula for medical students, advanced practice nursing students, and primary care residents. The legislation further stipulates that the project cannot require patients to receive a referral from a participating physician to receive specialist care, unless otherwise required by law. 
 
The advisory group is required to submit findings and recommendations six months, one year, and two years after the first funding for the pilot is released. Furthermore, the law added three additional duties specific to medical homes to the Health Care Coverage and Quality Council within the Ohio Department of Insurance; however, the Department of Insurance has since disbanded the council.
 
More information on the Ohio pilot can be found in the advisory committee’s final work product report. Minutes for each of the advisory groups meetings can be found here.
 
Federal Support: HealthBridge, serving the greater Cincinnati area (including parts of Kentucky and Indiana), has received a Beacon Community Grant.
 
Last Updated: January 2012

 

 
Forming Partnerships
Substitute House Bill 198 (128th General Assembly) established an eighteen-member patient-centered medical home (PCMH) education advisory group. Membership statutorily includes:
 
Voting:
  • Four individuals with expertise in training and educating primary care physicians appointed by of the deans of four of the state’s allopathic and osteopathic medical schools;
  • One individual with expertise in training and educating advanced practice nurses appointed by the Ohio Council of Deans and Directors of Baccalaureate and Higher Degree Programs in Nursing;
  • Two individuals appointed by the Ohio Academy of Family Physician;
  • One individual appointed by the Ohio Chapter of the American College of Physicians;
  • One individual appointed by the American Academy of Pediatrics;
  • One individual appointed by the Ohio Osteopathic Association;
  • One individual appointed by the Ohio Nurses Association;
  • One individual appointed by the Ohio Association of Advanced Practice Nurses; and
  • One member of the Health Care Coverage and Quality Council (now defunct) appointed by the superintendent of insurance.
Non-voting, ex officio:
  • The state Medicaid Director (or a designee);
  • The Director of Health (or a designee);
  • The Chancellor of the Ohio Board of Regents (or a designee);
  • The Executive Director of the State Medical Board (or a designee); and
  • The Executive Director of the Board of Nursing (or a designee).
The advisory group also hosted a statewide webinar and four regional town hall meetings to educate prospective practices and receive feedback from stakeholders.
 
In addition to administering the pilot, the act directs the advisory group to work jointly with state medical and nursing schools to develop new curricula to prepare future primary care providers for the PCMH model of care.
Defining & Recognizing a Medical Home
Definition: Substitute House Bill 198 (128th General Assembly) specifies that: “the patient centered medical home model of care is an enhanced model of primary care in which care teams attend to the multifaceted needs of patients, providing whole person comprehensive and coordinated patient centered care.”
 
Recognition: TransforMED evaluated pilot applicants for their potential to become patient-centered medical homes. Also, while there are no current recognition requirements to participate, the patient-centered medical home education advisory group referenced the 2011 NCQA medical home standards in their final work product report.
Aligning Reimbursement & Purchasing
Substitute House Bill 198 (128th General Assembly) requires the patient-centered medical home education advisory group to reimburse up to 75 percent of a practice’s health information technology investments for participating primary care practices (including training and technical support). Ohio is using meaningful use incentives in the HITECH Act to meet this requirement.
Supporting Practices
Substitute House Bill 198 (128th General Assembly) requires participating practices to receive comprehensive training on medical home operations, including leadership training, scheduling changes, staff support and care management.
Measuring Results

The patient-centered medical home (PCMH) education advisory group selected a number of practice and curriculum metrics. The selected metrics fall into six categories:

  1. Core clinical outcome metrics;
  2. Enhanced clinical outcome metrics;
  3. Patient, staff, and student satisfaction survey outcomes;
  4. Access to care metrics;
  5. Practice operations/financials metrics; and
  6. Curriculum/training metrics

For specific measures selected, please see pages 7-8 of the advisory group’s final work product report.

 

No further information is available.