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The Virginia Department of Medical Assistance Services (DMAS) operates a primary care case management program (PCCM) in the far southwestern part of the state that it is seeking to change to a medical home model.  DMAS has initiated a research and communication effort with providers and other state Medicaid agencies to develop a pilot medical home program in this area which will consist of primary care, dental, behavioral health, disease and case management, and other services. The pilot, which the state aims to launch in 2011, will build on the existing PCCM program. The pilot is being explored with the following stakeholders: Southwest Virginia Community Health Systems, Inc. (SVCHS), an FQHC located in rural southwest Virginia, Community Care Network of Virginia, Inc. (CCNV), which provides administrative and contracting services for the Federally Qualified Health Centers (FQHCs) in Virginia, and Carilion Health System.

Additionally, in March 2010, the Virginia General Assembly passed HJ 82, which “[d]irects the Joint Commission on Health Care to review available information …about chronic health care home systems in other states to develop recommendations related to the development of a system of chronic health care homes in the Commonwealth.”

Targeted population: Medicaid and FAMIS (CHIP) PCCM members assigned to SVCHS.

Last updated: December 2010

Forming Partnerships To support the development of the medical home pilot, DMAS has formed a partnership with Community Care Network of Virginia, Inc. (CCNV), which provides administrative and contracting services for the Federally Qualified Health Centers (FQHCs) in Virginia. DMAS also has plans to engage several other critical stakeholders including community service boards, payers, and the state chapters of the AAFP and AAP.
Measuring Results Community Care Network of Virginia will assist in providing data analysis services for the project. To the extent possible, the pilot will draw on existing quality measures to examine improvements in clinical quality and health outcomes. Medicaid cost containment measures will also be examined.