Husky Health Person-Centered Medical Home
Program Location:
Hartford, CT
Number of Practices:
41
Payer Type:
Medicaid
Payers:
Connecticut Medicaid
Accreditation/Recognition:
NCQA
Reported Outcomes
Description:
In January 2012, Connecticut's Department of Social Services introduced a person-centered medical home (PCMH) initiative within their redesigned HUSKY Health program. Under this initiative, Connecticut Medicaid provides new payment incentives to practices and clinics that demonstrate a higher standard of person-centered medical care. Eligible participants include independent physician groups or solo pracitces, Federally Qualified Health Centers, and hospital outpatient clinics. To qualify as a PCMH, a practice must be recognized by the National Committee for Quality Assurance (NCQA) as a Level 2 or Level 3 PCMH. Primary care services must account for at least 60% of a practitioner's time across all payers in order to qualify for enhanced reimbursements for PCMH services.
To assist practices with the PCMH transformation process, the state has a "Glide Path" option that provides financial and technical support for practices that are preparing to seek PCMH qualification through NCQA recognition.
Related News & Resources
Payment Model:
Practices and clinics that demonstrate a higher standard of person-centered primary care service delivery will qualify for a higher level of reimbursement for primary care services. Practices are also eligible for additional financial incentives based on performance measures. Up to 125% of estimated annual incremental PCMH costs are reimbursed through a hybrid approach:
- Start-up Supplemental Payment (small independent practices only)
- PCMH Participation Fee Differential Payment (Glide Path practices receive a portion of this fee)
- PMPM Performance Payments (excludes Glide Path practices)
- Year 1: Incentive payment for achieving NCQA Level 2 or 3 recognition
- After Year 1: Improvement payments to practices that demonstrate 5-10% improvement over their previous year's performance or that fall in the 90-100th percentile relative to all qualified PCMH practices
Click here for more information pertaining to the Husky Health Person-Centered Medical Home program.
Improved Patient/Clinician Satisfaction:
Connecticut Department of Social Services Report (FY 2015)
- Achieved an overall member satisfaction rating of 91.1% among adults and 96.1% on behalf of children
- Immediate access to care increased to 92.5% of the time, when requested by adults, and 96.7% of the time, when requested on behalf of children.
- Among a number of measures of courtesy and respect shown to HUSKY members, communication before and during care, PCMH providers were rated overwhelmingly positively by HUSKY members.
Cost Savings:
Hartford Courant (July 2014)
- 2% reduction in per person costs
- state distributed $2.4 million in enhanced payments to 15 certified medical homes and 1 hospital outpatient primary care clinic
Increased Preventive Services:
Hartford Courant (July 2014)
- children seen in a medical home were 10% more likely to receive recommended EPSDT screenings
Other Outcomes:
Hartford Courant (July 2014)
- 32% increase in participating providers over 18 months
Last updated December 2015
