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The West Virginia Bureau of Medical Services (Medicaid) has actively partnered with the multi-stakeholder West Virginia Health Improvement Institute (WVHII) to promote medical home development. Currently, a limited number of practices are participating in the Medical Home Performance Incentive Pilot developed by the WVHII’s Measurement Work Group. It should be noted that although Medicaid fee-for-service is not participating, at least one Medicaid managed care plan is participating.
Federal Support: West Virginia 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. The state is working closely with the West Virginia Health Improvement Institute and is targeting March 2012 to conclude its planning work.
Last updated: February 2011
| Forming Partnerships |
The West Virginia Health Improvement Institute, a partner of West Virginia Medicaid, provided a multi-stakeholder forum for development of the Medical Home Performance Incentive Pilot.
The West Virginia Bureau of Medical Services is also leading a stakeholder advisory group for Affordable Care Act Section 2703 Health Homes that is open to all interested stakeholders. This advisory group includes four workgroups:
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| Defining & Recognizing a Medical Home | Recognition: Practices participating in the Medical Home Performance Incentive Pilot were expected to apply for NCQA PCMH Recognition within nine months of the project start date. |
| Aligning Reimbursement & Purchasing |
Providers and payers participating in the Medical Home Performance Incentive Pilot agreed to share 5 percent of net savings (2.5 percent to providers, 2.5 percent to payers.) Providers also received compensation for lost revenue during learning sessions and NCQA PCMH application costs.
Payer and provider participation in the Medical Home Performance Incentive Pilot is voluntary. The following payers are participating:
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| Supporting Practices |
Practices participating in the Medical Home Performance Incentive Pilot received a technical assistance package valued at $25,000 per practice, including:
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| Measuring Results |
The Medical Home Performance Incentive Pilot has focused on the following outcomes:
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