More Medical Home Building Opportunities for States

At State Refor(u)m, we were intrigued by a confluence of medical home-related announcements this week. To learn more, I interviewed Mary Takach, a Program Manager at NASHP immersed in state medical home initiatives. Here are the highlights:
1. Medicare will be a payer in state medical homes initiatives for the first time. TheCenter for Medicare and Medicaid Innovation announced that Medicare will be partnering with Medicaid in existing state medical home initiatives. Eight states have already been selected to participate in a demonstration project (Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan, and Minnesota). The demonstration will include up to 1,200 medical homes that will serve up to one million Medicare enrollees. This is the first time that Medicare has agreed to be a payer in multi-payer medical home initiatives. These initiatives allow states to pool funds across major payers to drive primary delivery system transformation at the practice level to achieve cost and quality goals.
2. More resources for state peer learning are on their way. NASHP received news that The Commonwealth Fund will fund a new round of technical assistance, allowing us to support up to 17 leading and emerging states in building medical homes. The technical assistance will help states expand the number of medical homes provided and Medicaid beneficiaries served; add new payers, like Medicare or commercial payers to existing efforts; or use other tools found in the Affordable Care Act (ACA) to improve existing medical homes. States that are interested in participating should be on the lookout for more information on NASHP’s website in January 2011 or can sign up to receive updates from our medhome builders listserv by contactingjbuxbaum@oldsite.nashp.org.
3. Federal guidance and a template for the chronic condition medical home option in Medicaid are now available. The Centers for Medicare & Medicaid Services recently announced guidance about the state plan option under the ACA (Section 2703) to develop health homes for people with chronic conditions, and a state plan amendment template that states will be able to submit online beginning in December 2010. This state plan option provides states an enhanced FMAP at 90% for two years for comprehensive health home services. NASHP produced and archived a webinar about this state option. The webinar features presentations from 5 states: Minnesota, Oklahoma, North Carolina, Pennsylvania, and Rhode Island, and a discussion of these states’ hopes and concerns about this option.
The ACA also provides a number of other tools that state can use to improve medical homes and the primary care delivery system, including:

• Enhanced reimbursement rates for primary care providers;
• Improved access to preventive services;
• Funding for community health centers, the National Health Service Corps, and the primary care residency training programs; and
• Increased infrastructure support for primary care providers like community health teams.

We know that states’ use of these new tools for medical home building will differ. Our goal atState Refor(u)m is to make it easy for you to find and learn about what other states are doing. Please send your state’s implementation resources to statereforum@oldsite.nashp.org.