Not Your Usual Suspects: Roles For State Agencies In PCMH Payment Reforms

The growth of multipayer patient centered medical home (PCMH) reform across the country, accelerated by the Affordable Care Act, offers the opportunity to widely transform the primary care delivery system. Recent Health Affairs research noted 17 multipayer PCMH initiatives had been launched since 2008; and with State Innovation Model (SIM) grants awarded to 39 states and territories, these numbers will grow — multipayer payment reform is a core requirement of SIM funding.

States have played a dominant role in multipayer PCMH initiatives with Medicaid agencies overwhelmingly providing the infrastructure and support, but there are other state departments and agencies that can be leveraged. This blog post will discuss how state insurance departments, State Employee Benefits, and Public Health departments and agencies in collaboration with Medicaid, private payers, and other stakeholders have undertaken significant roles to strengthen multipayer PCMH efforts.