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November-December 2010 St@teside

States Selected for Participation in CMS Medical Homes Demonstration

On November 16, 2010, the Centers for Medicare & Medicaid Services (CMS) announced the eight states selected to participate in its Multi-Payer Advanced Primary Care (APC) Practice Demonstration project. This project will allow Medicare to participate with Medicaid and private insurers in state-based medical home initiatives. Medical homes are one type of delivery system reform aimed at improving how primary care is delivered by creating more coordinated, patient-centered care. The demonstration project will evaluate the impact on how providers deliver care using coordinated payments from Medicare, Medicaid, and private insurers. Participating practices will receive a monthly care management fee to cover the costs associated with care coordination, improved access, patient education, and other services. The eight states selected to participate in the demonstration project are Maine, Michigan, Minnesota, New York, North Carolina, Pennsylvania, Rhode Island, and Vermont, The demonstration will be operational in early 2011, and will ultimately include approximately 1,200 medical homes serving up to one million Medicare beneficiaries.

In order to qualify for the demonstration, state initiatives must:
  • Be conducted under state auspices;
  • Have promotion of the APC model as its central purpose;
  • Include Medicaid and substantial participation by private health plans;
  • Have substantial support by primary care providers;
  • Include mechanisms for community support of participating practices; and
  • Be coordinated with state health promotion and disease prevention efforts.

For more information, see the press release from CMS and the demonstration’s Fact Sheet.