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After the Governor’s Health Care Implementation Committee identified Patient-Centered Medical Home (PCMH) implementation as a priority, Gov. C.L. “Butch” Otter created the Idaho Medical Home Collaborative (IMHC) in Executive Order 2010-10. The Idaho Department of Insurance oversees the IMHC, and the Governor appoints all members (including payer, provider, and patient representation). The IMHC provides recommendations to the Department of Insurance and the Governor regarding:

  • Provider qualifications and standards;
  • A PCMH definition;
  • Payment methodologies;
  • Consumer and provider engagement;
  • Care coordination and case management guidelines;
  • Health data exchange; and
  • Evaluation measures, including cost- and quality-based outcomes measures.
The IMHC is working closely with the Safety Net Medical Home Initiative and expects to launch a multi-payer pilot medical home program in 2012. The IMHC is required to report to the Department of Insurance and to the Governor quarterly. 
 
Federal Support: Idaho has received a planning grant from the Centers for Medicare & Medicaid Services (CMS) to develop a state plan amendment to implement Section 2703 of the Affordable Care Act (ACA), establishing health homes for Medicaid enrollees with chronic conditions.
 
Furthermore, the Washington State Beacon Community of the Inland Northwest serves northern Idaho.
 
Last Updated: May 2012
 
Forming Partnerships
Gov. C. L. “Butch” Otter created an eight–member multi-stakeholder Governor’s Select Committee on Health Care in Executive Order 2007-13. The Select Committee was charged with providing recommendations from the Idaho Health Care Summit, including advancing medical homes. As a result of the Select Committee’s recommendations, Gov. Otter established the Idaho Medical Home Collaborative (IMHC) in Executive Order 2010-10. 
 
Participation in the IMHC includes:
  • Payers (including Medicaid, Blue Cross of Idaho, Regence, and PacificSource Health Plans);
  • State officials from the Governor’s Office, the legislature, and state agencies;
  • Providers and their representative organizations (including the Idaho Academy of Family Physicians, the Idaho Academy of Pediatrics, the American College of Physicians, the Idaho Medical Association; the Idaho Hospital Association; the Idaho Primary Care Association; and the Veteran Administration (VA) Medical Center; and
  • Patient and employer representatives.
The IMHC established Payment Reform and Practice Transformation workgroups in Fall 2010.
Defining & Recognizing a Medical Home
Definition: The Idaho Medical Home Collaborative definition of medical home: “a model of primary care in which patients receive enhanced access to a primary care provider and a clinical care team. In the medical home model of care, services are well-coordinated, and clinicians focus on preventive care, track patient data, and conduct quality improvement activities to meet patients’ needs.”
 
Recognition: The Idaho Medical Home Collaborative has recommended adopting the 2011 NCQA PCMH recognition criteria.
Aligning Reimbursement & Purchasing
An Idaho Medical Home Collaborative workgroup composed of payers and providers working together to identify sustainable common payment methodology.
Supporting Practices
Practices participating in the Safety Net Medical Home Initiative, a partnership between The Commonwealth Fund, Qualis Health, and The MacColl Institute for Healthcare Innovation at the Group Health Research Institute, receive practice transformation technical assistance to facilitate practice transformation to improve enhanced access, care coordination and patient experience. The Safety Net Medical Home Initiative is also funding a Medical Home Facilitator in each participating practice.
Measuring Results
A proposed Idaho Medical Home Collaborative workgroup will develop common quality, outcome, and cost measures.