Developing Infrastructure and Community Linkages
States are key facilitators when it comes to building community infrastructure to support multi-payer pilots, such as information technology, shared practice supports, and behavioral health integration.
Also see the Supporting Practices section of NASHP’s Medical Home Map and the Support for Infrastructure section of NASHP’s State Accountable Care Activity Map.
- Community Care of North Carolina. 2013. “CCNC: Community Care of North Carolina.” https://www.communitycarenc.org/.Community Care of North Carolina pioneered a model of community network-based practice support on which many states have since built. The statewide program is supported by multiple payers, including Medicare through CMS’s Multi-payer Advanced Primary Care Practice Demonstration, in seven rural North Carolina counties.
- Maine Quality Counts. 2013. “Maine Patient-Centered Medical Home Pilot – Community Care Teams.” https://www.mainequalitycounts.org/page/896-654/community-care-teams.Maine’s multi-payer patient-centered medical home pilot features multi-disciplinary community care teams to support practices, act as a link to behavioral health providers and social workers, and connect patients with community resources. The state launched two additional community care teams in January 2013, selected through a Request for Proposals process.
- Silow-Carroll, Sharon. 2013. “Medicaid Is One of Multiple Payers in Vermont’s Health Care Reforms.” The Commonwealth Fund.Vermont’s multi-payer patient-centered medical home program features community health teams that provide care coordination and health education, among other services, for complex or high-needs patients.
- Takach, Mary, and Jason Buxbaum. 2011. “Developing Federally Qualified Health Centers into Community Networks to Improve State Primary Care Delivery Systems.” National Academy for State Health Policy.Discusses opportunities for states to support small practices in caring for complex and high-risk patients by fostering connections with federally-qualified health centers (FQHCs).
- Kaye, Neva, Jason Buxbaum, and Mary Takach. 2011. “Building Medical Homes: Lessons from Eight States with Emerging Programs.” National Academy for State Health Policy.Describes state strategies for supporting practices in medical home transformation, including infrastructure development such as health information technology and shared practice supports like community care teams or networks (see pg. 14).
- Takach, Mary, Anne Gauthier, Kristin Sims-Kastelein, and Neva Kaye. 2010. “Strengthening Primary and Chronic Care: State Innovations to Transform and Link Small Practices.” National Academy for State Health Policy.Highlights state efforts to support small practices in delivering efficient and effective care as patient-centered medical homes, including three multi-payer initiatives in Colorado, Pennsylvania, and Vermont.
- Kaye, Neva, and Mary Takach. 2009. “Building Medical Homes in State Medicaid and CHIP Programs.” National Academy for State Health Policy.Discusses state policies to support primary care through external and infrastructure development, including community care teams or networks, health information exchanges, and patient engagement (see pg. 31).