- Pennsylvania’s Chronic Care Initiative (CCI) began as a project of the state’s Chronic Care Commission, which former Governor Ed Rendell created by Executive Order in 2007. Phase I of CCI (2008-2011), which combines elements of Wagner's Chronic Care Model and the patient-centered medical home, was staged in seven regional rollouts. The program model varied regionally during Phase I, with differences over requirements to obtain NCQA medical home recognition, payments to practices, and other features. The Southeast Pennsylvania region was the first to launch, beginning with a learning session in May 2008. Six payers participated in the Southeast rollout, and practices were encouraged to focus on diabetes and pediatric asthma. Subsequent rollouts in other regions of the state followed similar models.
- The West Virginia Bureau of Medical Services (Medicaid) has actively partnered with the multi-stakeholder West Virginia Health Improvement Institute (WVHII) to promote medical home development. Recently, West Virginia completed a two-year Medical Home Performance Incentive Pilot developed by the WVHII’s Measurement Work Group. Three payers, including a Medicaid managed care plan and the state employee health plan, funded technical assistance to support NCQA Patient-Centered Medical Home recognition and participating practices were eligible to receive shared savings.
- Federal Support: On November 21, 2013, CMS approved a Section 2703 health home state plan amendment, creating health homes for Medicaid enrollees with a) two chronic health conditions; b) one chronic health condition and the risk of developing another; or c) one serious mental illness. The SPA became effective as of July 2, 2013. To learn more about Section 2703 Health Homes, visit the CMS Health Homes webpage.Last Updated: April 2014
- The NH Citizens Health Initiative has convened a multi-payer, multi-stakeholder medical home project since January 2008. Payments to pilot practices began on June 1, 2009, and ended on December 31, 2011. While Medicaid helped design the program, it did not join as a participating payer. Further information on the program is available online here. The NH Citizens Health Initiative is supported by the New Hampshire Department of Insurance, as well as a variety of other funders. The NH Citizens Health Initiative is also leading a multi-year, multi-stakeholder accountable care organization (ACO) pilot. Further information is available here.
- The Nebraska Department of Health and Human Services (DHHS), guided by a governor-appointed physician Medicaid Medical Home Advisory Council, launched a two-year medical home pilot. The program operated under the authority of a 1932(a) state plan amendment, approved by CMS in January 2011. This pilot was limited to two practices selected through a Request for Information process in February 2011; the pilot launched in February 2011 and ran through February 2013.Nebraska began its process in 2009 with a statutory definition of the medical home and a legislative mandate to implement a pilot. The state then:
Engaged several key stakeholders;
- Several medical home projects are underway in Rhode Island. - See more at: http://www.nashp.org/med-home-states/rhode-island#sthash.MAV6PDOr.dpufSeveral medical home projects are underway in Rhode Island. - See more at: http://www.nashp.org/med-home-states/rhode-island#sthash.MAV6PDOr.dpuf
- Thursday, June 14, 20123:00 pm - 4:30 pmEDT
Section 2703 of the Affordable Care Act provides states with an enticing opportunity to provide health homes for chronically ill Medicaid enrollees. States are able to draw an enhanced federal match to integrate primary care with behavioral health and long-term services and supports for two years. Join Melinda Abrams of The Commonwealth Fund and state officials from New York and Oregon on this NASHP medical home webinar to learn why these states pursued the health home option and the lessons learned during implementation.
- Iowa’s 2008 Health Care Reform Act (House File 2539) charged the Iowa Department of Public Health with convening a Medical Home System Advisory Council to craft recommendations for implementing a statewide patient-centered medical home (PCMH) system. The stated purpose of a patient-centered medical home is to provide for the, “coordination and integration of care, focused on prevention, wellness, and chronic care management, using a whole person orientation through a provider-directed medical practice.” The Advisory Council has also convened a Multipayer Collaborative Workgroup to explore the potential for a multi-payer medical home project in the state.
- 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.
- In 2007 the Kansas Health Policy Authority (KHPA) (now known as the Kansas Division of Health Care Finance) delivered a comprehensive health reform plan to the Legislature and the Governor intended to improve health in Kansas. A key component of the plan was promotion of the medical home model. In 2008, Kansas policymakers demonstrated support for adopting the medical home concept for Medicaid, Children’s Health Insurance Program (CHIP), and state employee enrollees by passing Sub. SB 81 (New Section 13), which defined the medical home in statute. Following passage of that legislation, KHPA has dedicated staff working with stakeholders to develop a Kansas-specific medical home model. The state has not set a launch date because of budget setbacks, but it continues to lay the foundation for a medical home program that can be implemented when fiscal matters improve.