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Idaho Medical Home Pilot A Multi-payer Initiative

Idaho Medical Home Pilot A Multi-payer Initiative. Denise Chuckovich, Deputy Director Idaho Department of Health and Welfare chuckovd@dhw.idaho.gov. Idaho Medical Home Pilot. Multi-payer Medical Home Pilot launched 1/1/2013 Convened by Idaho Medical Home Collaborative

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Idaho Medical Home Pilot A Multi-payer Initiative

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  1. Idaho Medical Home PilotA Multi-payer Initiative Denise Chuckovich, Deputy Director Idaho Department of Health and Welfare chuckovd@dhw.idaho.gov

  2. 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

  3. 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 practicesbut 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.

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