People with Chronic Conditions

  • Hawaii

    In May 2011, Hawaii Governor Neil Abercrombie announced his administration’s intent to secure medical homes for Hawaii’s 270,000 Med-QUEST (Medicaid) beneficiaries. Integrating behavioral health and social services with primary care will be a major goal of the state’s medical home efforts. 
    Hawaii is currently working to develop and obtain approval for a health homes state plan amendment (SPA). A State Plan Option Collaborative has been meeting to select chronic conditions to focus on, define what “health home” will mean in Hawaii, reach consensus on culturally competent health home service definitions, agree on a payment methodology, and identify key measures to track. The state is now carrying out a workplan for developing the health homes SPA.
  • Connecticut

    In January 2012, Connecticut introduced a person-centered medical home (PCMH) initiative within their redesigned HUSKY Health program. Under this initiative, Connecticut Medicaid provides new payment incentives to practices and clinics that demonstrate a higher standard of person-centered medical care. In order to receive enhanced payments for medical home services, providers must be an active licensed physician, nurse practitioner or physician’s assistant specializing in general internal medicine, geriatrics, family medicine or general pediatrics that functions as a primary care provider for a set panel of patients. Furthermore, primary care must account for 60 percent of the practitioner’s time across all payers.  
  • Tennessee

    We have no information on medical home activity that meets the following criteria: (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.
    Federal Support: Tennessee has received a duals demonstration grant from the Centers for Medicare & Medicaid Services (CMS) to “coordinate care across primary, acute, behavioral health and long-term supports and services for dual eligible individuals.”
    Last updated: June 2013
  • Washington

    Washington State has pursued multiple efforts to advance medical homes:
  • Colorado

    Colorado’s medical home efforts began in 2001 with the Colorado Medical Home Initiative (CMHI). This program, administered by the state’s Department of Public Health and Environment (CDPHE), was charged with ensuring that all children receive comprehensive coordinated care within a Medical Home. Chapter 346 of the 2007 Session Laws of Colorado required the Department of Health Care Policy & Financing (HCPF), the state agency that administers the Medicaid and SCHIP programs, to work with CDPHE to maximize the number of children served by medical homes in Medicaid and SCHIP. A non-profit organization known as the Colorado Children's Healthcare Access Program (CCHAP) also works collaboratively with state agencies in the Medical Homes for Children Program
  • Georgia

  • Utah

    Utah is actively building medical homes for children through a Children’s Health Insurance Program Reauthorization Act (CHIPRA) quality demonstration grant. The $10,277,361 grant was awarded to an Idaho-Utah partnership and runs from February 2010 through February 2015. It is supporting the Utah Children’s Healthcare Improvement Collaboration (CHIC) in hosting learning collaboratives, increasing pediatric practices’ use of health information technology, and helping 12 Utah practices become medical homes. The practices, which together serve more than 80,000 children, will be asked to focus on improving care for children with special health care needs.  According to the project’s CHIPRA proposal, payers will share the non-CHIPRA covered costs in proportion to market share.
  • South Carolina

    In early 2011, the Centers for Medicare & Medicaid Services (CMS) approved South Carolina’s request to expand its Healthy Connections Choices program to require that most beneficiaries enroll in managed care. Healthy Connections Choices enrollees have the option to join a managed care plan or a primary care case management program known as the Medical Homes Network Program.
  • Rhode Island

    Several medical home projects are underway in Rhode Island.
    Chronic Care Sustainability Initiative (CSI-RI)
    The multi-payer CSI-RI was first convened by the Rhode Island Office of the Health Insurance Commissioner in June 2006, and corresponded with a state directive for health plans to invest an additional $100 million in primary care. Payment to participating practices began in October 2008 with five pilot sites. Five payers, including Medicaid fee-for-service, Medicaid managed care organizations, and commercial plans have supported the original five pilot sites as well as eight expansion sites that joined the project in April 2010 and three more that joined in October 2012. Medicare announced in 2011 that it would begin making payments on behalf of Medicare fee-for-service beneficiaries. The project now has the participation of nearly 100% of Rhode Island payers and purchasers.
  • Montana

    Montana has convened a large group of diverse stakeholders to plan a statewide multi-payer medical home pilot. Initially convened by Medicaid, Montana’s Commissioner of Securities & Insurance took the leadership role in September 2010 in order to more effectively engage commercial payers.

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