The patient-centered medical home
is the foundation of Arkansas' healthcare system transformation
efforts, but practices have had a hard time implementing the practice model, so the state has hired medical home pioneers Community Care of North Carolina to help.
CCNC will be paid $750,000 in an annual contract that can be renewed up to seven times, said Sheena Olson, Arkansas Medicaid assistant director for programs and provider management. Practices are not required to use CCNC's services, but many have indicated that they can use the assistance.
Practices that implement the medical home model are being paid a risk-adjusted per-member-per month fee to cover the cost of care-coordination services medical homes provide. The average fee is $5, and Olson said doctors were telling her “thanks for paying us to do this, but how do we set up the infrastructure to get started?”
will assist with setup and training for practices to provide care coordination, population health management and quality improvement efforts.
“We are gratified that the success of our care-management, medical home and population health program in North Carolina has led to an expansion of that approach in other states,” Denise Levis Hewson, CCNC senior vice president for network development and state programs, said in a news release
. “We believe we can make a positive difference in their care while helping to conserve tax dollars.”
CCNC will be the second vendor hired by Arkansas to help with medical home implementation. Practices also can receive 30 hours of consultation from Seattle-based Qualis Health
free of charge.
Olson said the medical home portion of the Arkansas Health Care Payment Improvement Initiative
was rolled out in January with the goal of getting 40% of the state's Medicaid beneficiaries assigned to a medical home practice. Instead, they were able to assign 70% of beneficiaries.
The program started with 600 participating doctors and has since grown to include 900, she said.
Olson acknowledged, however, that practices will not make a profit off the care-coordination fees meant to cover expenses. Instead, practices will benefit from a shared-savings program
that has set a 2014 medium cost, per-beneficiary threshold of $2,032. Practices will be eligible to receive 50% of the difference between the practice's average cost and the medium-cost threshold.
Olson said the next step in the program is to increase involvement from other payers.
“This is not just a pilot implemented here and there, and this is not just a Medicaid-only initiative,” she said. “We'll need all payers to sustain it.”Follow Andis Robeznieks on Twitter: @MHARobeznieks