West Virginia

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

This award is part of the Health Care Innovation Awards program, a Department of Health and Human Services initiative investing up to $1 billion to test promising new approaches that aim to improve health care and lower program costs for recipients of Medicare, Medicaid and the Children's Health Insurance Program (CHIP).

Highmark Blue Cross Blue Shield West Virginia has teamed up with the Partners in Health Network (PIHN) to offer a patient-centered medical home (PCMH) program to approximately 8,000 Highmark West Virginia members throughout the state of West Virginia.

Under PEIA’s Medical Home Program, a personal medical home is a health care provider with whom the PEIA member has a continuous professional relationship for management and coordination of all aspects of the member’s preventive, acute and chronic health care services. With a commitment to high quality, cost-effective care through a patient-centered approach, the Medical Home also acts as a patient advocate and assists with linkage to community services and health care outside the Medical Home’s expertise.

The West Virginia Health Improvement Institute is a partner organization involved in the Tri-State Children’s Health Improvement Consortium (T-CHIC), which involves a collaborative effort of three states - Alaska, Oregon, and West Virginia.  The project is focused on establishing and evaluating a national system for children's health care quality. T-CHIC is funded by the Children’s Health Insurance Program Reauthorization ACT (CHIPRA) and builds on existing state and practice level change efforts.