In 2010, the Virginia Department of Medical Assistance Services (DMAS) began developing plans for a medical home pilot with a federally qualified health center (FQHC) in southwest Virginia. The goal of the pilot was to improve primary care delivery within the framework of an existing primary care case management (PCCM) program. The expansion of Medicaid managed care to Southwest Virginia in July 2012 required a shift in plans for the pilot. Contracts between the state’s Medicaid MCOs and DMAS now require the MCOs to partner with DMAS in developing the southwest Virginia medical home pilot. Full contract language is available online here.
Last Updated: December 2013
The Virginia Department of Medical Assistance Services (DMAS) has engaged a variety of stakeholders to develop the medical home pilot, including:
|Defining & Recognizing a Medical Home||
Definition: The Virginia Department of Medical Assistance Services’ (DMAS) contract with Medicaid managed care organizations (MCOs) identifies the following principles as “core” aspects of the medical home model:
|Aligning Reimbursement & Purchasing||The Virginia Department of Medical Assistance Services’ (DMAS) contracted Medicaid managed care organizations (MCOs) are establishing quality benchmarks that will help determine provider rewards. The MCOs have communicated that they will base initial goals on the measures selected by DMAS for its quality improvement program.|