Connecticut to Introduce Medical Home Initiatives

In January 2012, Connecticut introduced a PCMH initiative within their redesign of the Medicaid program HUSKY health. Connecticut’s Medicaid program will provide new payment incentives to health care practices and clinics demonstrating higher standards of patient-centered medical care.Additional state support will be provided to practices that currently are not recognized by NCQA as meeting Level 2 or Level 3 status for a PCMH.   This “Glide Path” option allows practices to participate in a three-phase program, each phase lasting six months, under which time the practice must meet specific qualifying measures for Levels 2 and 3. Attainment of these higher NCQA levels is a requirement in order for practices to receive full payment incentives.  Reimbursement for this program is estimated at 125% of the costs associated with implementing medical homes. In order to address uninsured residents who do not qualify for Medicaid or Medicare services and are not offered employer coverage, Connecticut established the SustiNet Health Partnership, which was tasked to design and implement a public health insurance program.  Written into the law is language requiring the creation of a PCMH advisory committee composed of physicians, nurses, consumer representatives and other selected qualified individuals.  In addition, this law mandates that medical home services be included in the standard benefits package developed by the Partnership. Financial incentives and administrative support will be provided by the state to participating health care organizations.  Results will be measured by tracking specific pediatric and adult outcomes and processes.  In addition, patient experience with PCMHs and the Medicaid provider network will be measured through customized surveys.