Half of state Medicaid programs are taking new approaches to provider payment—focusing on chronically ill populations, using shared teams, aligning payments with national quality standards, and implementing shared-savings programs—to help primary care practices become patient-centered medical homes for their low-income patients.
- 19 of the 25 states that have implemented payment changes are paying providers a permember per-month care management fee to perform the functions of a PCMH.
- Minnesota designed a care management fee that was adjusted according to the number of a patient’s chronic conditions.
- Many states are asking practices to link payments with meeting standards of care, like those set by the National Committee for Quality Assurance (NCQA).
As you continue to work on PCMH development at your organization, consider these innovative payment reforms occurring around the country. Not only is the work you are doing improving patient care, but also innovations such as these are attempting to align payment with the higher quality of care delivered.