Medical Homes & Patient-Centered Care

A medical home is an enhanced model of primary care that embraces comprehensive and coordinated patient-centered care emphasizing enhanced access, quality, and safety. First advanced by the American Academy of Pediatrics in the 1960’s, the concept gained new momentum in 2007, when four major physician groups agreed to a broader vision of the model in the Joint Principles of the Patient-Centered Medical HomeRead More

Since 2007, NASHP has been tracking and supporting state efforts to advance medical homes for Medicaid and CHIP participants. As of March 2015, 46 states and the District of Columbia have adopted policies and programs to advance medical homes in their Medicaid and/or CHIP programs. Medical home activity must meet the following criteria for inclusion on this map: (1) program implementation (or major expansion or improvement) in 2006 or later; (2) Medicaid or CHIP agency participation (not necessarily leadership); (3) explicitly intended to advance medical homes for Medicaid or CHIP participants; and (4) evidence of commitment, such as workgroups, legislation, executive orders, or dedicated staff. NASHP’s interactive medical home map allows you to click on a state to learn about its efforts.

Over the past few years, there has been a notable increase in the number of states that are implementing medical home programs. NASHP has fostered a great deal of this work. A few projects in our medical home portfolio include:

  • NASHP is currently supporting six states that are developing and implementing programs to better integrate primary care, behavioral health, and social services for individuals with chronic medical conditions and comorbidities. This learning collaborative, Supporting State Strategies to Design and Deliver Whole-Person Care in Ambulatory Settings, is the fifth in a series funded by The Commonwealth Fund. In the previous learning collaboratives (2007-2014), NASHP provided direct technical assistance to 25 states advancing medical homes care in Medicaid/CHIP and/or public-private multi-payer initiatives.
  • NASHP is tracking and analyzing policy context and implementation activities in and across the states participating in the Centers for Medicare and Medicaid Services (CMS) Evaluation of the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration. The first annual report was published in January 2015.
  • NASHP provided summary analyses of the first 15 approved health home state plan amendments to CMS and contributed to the 2014 Interim Report to Congress on the Medicaid Health Home State Plan Option.

For information on medical home initiatives that do not include Medicaid or CHIP participation, we encourage you to visit the Patient-Centered Primary Care Collaborative.

Activities
Medical Home Activity

States with medical home activity for Medicaid/CHIP since 2006

aco gray map key None
orange Medical home activity, no payments to medical homes
yellow Payments to medical homes underway


Medical Home Activity
Multi-Payer Initiatives

States with an active role in a multi-payer medical home initiative

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dark-purple Multi-payer planning activity underway
lavender Multi-payer payments to medical homes underway


Multi-Payer Medical Home Initiatives
2703 Health Homes
ACA Section 2703 Health Homes

States pursuing ACA Section 2703 Health Homes

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dark-blue State with health home planning grant
blue State with approved health home state plan amendment(s)
aqua State with both


ACA Section 2703 Health Homes
Qualification Standards
States aligning medical home payment with national or state-developed qualification standards

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red ACO map key State aligns medical home payments with national or state-developed qualification standards


Qualification Standards
Shared Support
States making payments to community-based teams or networks to support primary care practices

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dark-green State is making payments to community based teams or networks to support primary care practices


Shared Support Teams

Development and ongoing updates of this webpage would not be possible without the generous support of The Commonwealth Fund.