- In early 2011, Arkansas’s Department of Human Services proposed an initiative they call “Transforming Arkansas Medicaid” (in later documents, “Transforming Arkansas Health Care”). The Arkansas Department of Human Services (which oversees Arkansas Medicaid) has partnered with two large private insurers in the state, Arkansas Blue Cross and Blue Shield and Arkansas QualChoice, to implement this broad payment and delivery system reform initiative.
- Federal Support: On January 29, 2013, the Centers for Medicare & Medicaid Services (CMS) approved Wisconsin’s state plan amendment (SPA) to implement Section 2703 of the Affordable Care Act, creating health homes for Medicaid enrollees with an HIV diagnosis and at least one other diagnosed condition or a risk of developing a second condition. AIDS Service Organizations in four counties are eligible to serve as health homes under this SPA, serving large urban areas including Green Bay, Madison, and Milwaukee. The SPA became effective on October 1, 2012. Wisconsin was a recipient of a planning grant from CMS to develop its state plan amendment. To learn more about Section 2703 Health Homes, visit the CMS Health Homes webpage.
- The Texas Medical Home Work Group has been meeting regularly for more than three years. This group, convened by the Texas Department of State Health Services, exists to, “to enhance the development of Medical Homes within the primary care setting.” Several state agencies are represented in the group, as are a wide range of stakeholders. The group serves as a forum to coordinate and share information on public and private medical home activities in the state. These activities have included:
A now-suspended plan for a $12 million Medicaid Health Home Pilot for children. Further information on the previously planned pilot is available in this National Academy for State Health Policy (NASHP) report.
- 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
- 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
- Chapter 224 of the Acts of 2012, signed in August 2012, includes a number of provisions specific to promoting the adoption of patient-centered medical homes (PCMHs) in Massachusetts. This legislation requires a newly formed Health Policy Commission to develop certification standards, a training program, and a model payment system for PCMHs by January 2014. Chapter 224 ensures that existing medical home initiatives, such as the PCMH Initiative described below, may proceed as planned.
- In 2009, New Mexico unanimously enacted Chapter 143 of the 2009 Laws, intended to provide medical homes for members of the state's Medicaid, Children's Health Insurance Program (CHIP), and State Coverage Initiative (SCI) program. SCI is a public-private managed care program in New Mexico that targets low-income adults without insurance working for small employers. The statute directs the New Mexico Human Services Department to apply for a waiver or state plan amendment to implement a medical home program, and to work with managed care contractors to "promote, and if practicable, develop” a medical home program.Participating SALUD! managed care organizations (MCOs) are providing grants to a small number of primary care practices in the state with the goal of achieving NCQA PCMH certification. Initial estimates indicate that over 45,000 members are participating in PCMH delivery models through the SALUD! medical home pilots.New Mexico Medicaid is focusing on four main objectives:
- 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.
- New York Medicaid is directly participating in two medical home initiatives created in Chapter 58 of the Laws of 2009, the 2009-2010 state budget.
A statewide Patient-Centered Medical Home Program for individuals enrolled Medicaid, Family Health Plus or Child Health Plus.
- 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.