Presentation on theme: "Idaho Medical Home Pilot A Multi-payer Initiative Denise Chuckovich, Deputy Director Idaho Department of Health and Welfare"— Presentation transcript:
Idaho Medical Home Pilot A Multi-payer Initiative Denise Chuckovich, Deputy Director Idaho Department of Health and Welfare
Idaho Medical Home Pilot Multi-payer Medical Home Pilot launched 1/1/2013 Convened by Idaho Medical Home Collaborative Idaho Medicaid responsible for pilot management Scope: 37 pilot clinic sites, 5211 members enrolled Key players include: Payers: Medicaid and three largest private payers in the state Providers: Medical association, Family Practice association, community health centers, private physicians, primary care residency program, rural clinics Others: state legislators, governor’s office, Department of Health and Welfare, Department of Insurance, consumers
Idaho Medical Home Pilot Infrastructure: Pilot staffed and managed through Idaho Medicaid Program, with oversight by Collaborative Payment model: PMPM for chronic DX, in addition to FFS Payment flow: No change from current payment methods Attribution and enrollment methods: Reflect each payer’s policies and practices Contractual relationships: Payers contract directly with practices but all practices sign Pilot MOU. Payers identify PCMH requirements. Most are consistent across payers. Data Flow: Practices select two or more measures from common list to report on. Data for all patients reported through a secure portal at Medicaid. Process for data feedback to providers under development.