The Medical Home System Advisory Council in Iowa recently discussed how to advance the medical home concept in the state. The purpose of the Council is to advise and assist the Iowa Department of Public Health (IDPH) on developing a statewide patient-centered medical home system as outlined in the state legislation (HF 2539).
The initial phase as entailed in the legislation will focus on providing a patient-centered medical home for children who are eligible for Medicaid. The second phase will focus on providing a patient-centered medical home for adults covered by the IowaCare Program and for adults eligible for Medicaid. The third phase will focus on providing a patient-centered medical home for children covered by the “hawk-i” program, adults covered by private insurance, and self insured adults. Plus state employees will be allowed to use the system.
Specifically, the legislation calls for IDPH to:
- Develop a plan and an organization structure to implement the system
- Develop standards and a process to certify medical homes
- Recommend a reimbursement methodology and incentives for participation
- Coordinate the requirements of the medical home system with the dental home for children
- Integrate the recommendations and policies developed by the Prevention and Chronic Care Management Advisory Council into the medical home system
- Provide oversight for all certified medical homes
- Evaluate the medical home system annually
Some other states are looking at developing the medical home concept. For example, Idaho, is studying the “Target for a Healthy Idaho” initiative that would provide each person access to a medical home. Other states such as Minnesota and Louisiana are gearing the medical home program to Medicaid enrollees and uninsured populations. New Hampshire’s Multi-Payer Medical Home Project however is a pilot involving all payers, including Medicaid and Medicare providers, and subject experts.
In another state legislative action, (SB 2394) was introduced in New Jersey. The bill calls for the State Medicaid program to establish a three year medical home demonstration project. The demonstration program would support primary care practices that use a medical home model and reward the practices for improved quality and improved patient outcomes. The primary care practices at a minimum will need to have a multi-specialty team available to provide patient-centered care coordination by using health IT and chronic care registries.
