Parent Programs

The programs listed here are national in scope, but are implemented across given states, regions, counties or local communities. Locally-implemented programs are often included as components of these larger PCMH-related initiatives in states.
Program Name Payer Type Description
ACA Section 2703 Health Homes Medicaid

The Medicaid Health Home State Plan Option, authorized under the Affordable Care Act (Section 2703), allows states to design health homes to provide comprehensive care coordination for Medicaid beneficiaries with chronic conditions.
Aetna Integrated Primary Care Behavioral Health Program Commercial

Aetna's Integrated Primary Care Behavioral Health Program supports a collaborative health care model that provides coordinated and effective services for individuals with mental health needs.
Aetna Patient-Centered Medical Home Program Commercial

Aetna's nationwide patient-centered medical home program has launched in several states, including New York, Massachussets, Connecticut, New Jersey, and Ohio; including a multi-year partnership with CMS Comprehensive Primary Care grantees.
Anthem - Enhanced Personal Health Care Commercial

Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs) operate under Anthem’s Enhanced Personal Health Care framework.  Based on the lessons and results of the ACO and PCMH pilots, Anthem launched Enhanced Personal Health Care in 2013 which represents its comprehensive,

Blue Cross Blue Shield Value-Based Care Program Commercial

The Blue Cross and Blue Shield Association (BCBSA) and BCBS Plans are spearheading initiatives to assure their 100 million members receive safe, high-quality, coordinated, and affordable care. Blue initiatives use an interconnected approach involving:
Cigna Collaborative Care Program Commercial

Cigna Collaborative Care (previously called Collaborative Accountable Care) is Cigna's approach to accountable care organizations, or ACOs.
CMS Comprehensive Primary Care Plus (CPC+) Multi-Payer

Comprehensive Primary Care Plus (CPC+) is a national advanced primary care medical home model that aims to strengthen primary care through a regionally-based multi-payer payment reform and care delivery transformation.
CMS Dual Eligible Demonstration Grant

A longstanding barrier to coordinating care for Medicare-Medicaid enrollees has been the financial misalignment between Medicare and Medicaid.
CMS Health Care Innovation Award (Round 2) Grant

The second round of Health Care Innovation Awards are funding grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health Insurance Program (CHIP), particularly those w
Direct Contracting Medicare

Direct Contracting (DC) is a set of voluntary payment model options aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare fee-for-service (FFS).  The payment model options available under DC create opportunities for a broad range of organizations
Humana Medical Home Program Commercial

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process.
Iora Health Commercial

Founded in 2011, Iora Health incorporates team-based care that puts the patient first as well as a payment system that is based on care, not billing codes and technology. 
Medicaid Section 1115 Waiver Medicaid

Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs.
Medicare Shared Savings Program

The Centers for Medicare & Medicaid Services (CMS) has established a Medicare Shared Savings Program (Shared Savings Program) to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs
Patient-Centered Outcomes Research Institute (PCORI) Programs Grant

PCORI solicits applications for proposals for patient-centered comparative clinical effectiveness research (CER) based on their National Priorities for Research and Research Agenda.
Primary Care First Medicare

Primary Care First: 
Foster Independence, Reward Outcomes
Transforming Clinical Practices Initiative (TCPI) Grant

The Transforming Clinical Practice Initiative is designed to help clinicians achieve large-scale health transformation.
U.S. Air Force Family Health Operations PCMH Military

To improve Air Force primary care and achieve better health outcomes for our patients, the Air Force implemented the Family Health Initiative (FHI) in 2009, which is a team-based, patient-centered approach building to the Patient-Centered Medical Home (PCMH) concept established by the American Ac
U.S. Army Community Based Medical Homes Military

In the Community Based Medical Home, the healthcare team develops a comprehensive care plan as soon as the patient enrolls and then proactively engages the patient as a partner in care.
U.S. Navy Medical Home Port Military

To implement PCMH principles, the Bureau of Medicine and Surgery (BUMED) formally developed its PCMH model Medical Home Port (MHP) and is in the process of implementing MHP across its enterprise. Medical Home Port helps provide primary care in a way that best meets the needs of Navy Medicine’s be
UnitedHealthcare PCMH Program Commercial

UnitedHealthcare currently operates 13 medical home programs in 10 states for the commercially insured population  These programs include more than 2,000 participating physicians and 300,000 members. 
Veterans Health Administration - Patient Aligned Care Team (PACT) Military

The VA’s Veterans Health Administration (VHA) operates one of the largest integrated health delivery systems in the United States, delivering comprehensive care to approximately five million Veterans.
Completed
Program Name Payer Type Description
Aligning Forces for Quality Grant

[ENDED IN 2015] Each of the Aligning Forces 4 Quality (AF4Q) communities has built its initiative around a core, multi-stakeholder leadership alliance working to advance the goals and activities of AF4Q at the local level.
CHIPRA Quality Demonstration Grant Grant

[ENDED IN 2015] In February 2010, the Centers for Medicare & Medicaid Services (CMS) awarded 10 gra
CMS Comprehensive Primary Care Initiative Multi-Payer

[Ended in December 2016] The Comprehensive Primary Care (CPC) initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care.
CMS Health Care Innovation Award (Round 1) Grant

 [ENDED IN 2014] The Health Care Innovation Awards are funding up to $1 billion in awards to organizations that are implementing the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and Children's Health In
CMS Health Care Innovation Award - PCMN Demonstration Grant

[ENDED] About 157,000 Medicare and Medicaid beneficiaries in 15 health systems and provider organizations across the nation are participating in a Patient-Centered Medical Neighborhood (PCMN) demonstration project as part of a collaboration among TransforMED, Phytel and VHA Inc.
CMS Pioneer ACO Grant

[Ended December 31st, 2016] The Pioneer ACO Model (as authorized by  Section 3021 of the Affordable Care Act) is designed specifically for organizations with experience offering coordinated, patient-centered care, and operating in ACO-like arrangements.
CMS State Innovation Model (SIM) Grant

[Ended] In Round One of the SIM Initiative, nearly $300 million was awarded to 25 states to design or test innovative health care payment and service delivery models in the form of Model Design, Model Pre-Test, and Model Test awards.
FQHC Advanced Primary Care Practice Grant

[Ended October 31st, 2014] The Federally Qualified Health Center (FQHC) Advanced Primary Care Practice demonstration will show how the patient-centered medical home model can improve quality of care, promote better health, and lower
Multi-Payer Advanced Primary Care Practice (MAPCP) Multi-Payer

[Ended in 2016] Under this demonstration, CMS will participate in multi-payer reform initiatives that are currently being conducted by states to make advanced primary care practices more broadly available.
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