People with Chronic Conditions

  • Washington

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

    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.
    Last Updated: April 2014
  • 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.
  • Missouri

    The Missouri legislature first promoted medical homes with the passage of SB577 of the 2007 Session Laws, known as the Missouri Health Improvement Act, which including a requirement that MOHealthNet (Medicaid) provide all beneficiaries with a health care home (left undefined in the legislation).
    The state is also supporting the Missouri Foundation for Health’s (MFH) Patient-Centered Medical Home Collaborative. MOHealthNet is not a participating payer (the program is currently limited to Anthem Blue Cross Blue Shield and United Healthcare), but practices in the MFH medical home program and MOHealthNet health home program will both participate in the same learning collaboratives. MFH describes the two programs as, “separate, but coordinated.” Additional information on the Missouri Medical Home Collaborative can be found in the RFA
  • Louisiana

    Act 243 of the 2007 Regular Legislative Session, known as the Health Care Reform Act of 2007, directed the state to develop and implement a medical home system of care called Louisiana Health First. The law further stipulated that the medical home system incorporate health information technology (HIT) and quality measures to increase access, improve quality, and provide sustainability in medical care for the Medicaid and low-income uninsured populations.  However, the Centers for Medicare & Medicaid Services (CMS) did not approve the Louisiana Health First Section 1115 waiver required to implement the program. Act 243 of the 2007 Regular Legislative Session required the Louisiana Department of Health and Hospitals (DHH) to implement the legislation as feasible if CMS did not approve the waiver.
  • Kentucky

    Federal Support: Kentucky 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. To learn more about Section 2703 Health Homes, visit the CMS Health Homes webpage.
    Last Updated: April 2014

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