Thursday, February 12, 2009

States Pursuing Medical Homes

Minnesota is moving forward on the medical home concept according to “Stateline Midwest” published by the Midwestern Office of the Council of State Governments. Minnesota has passed legislation in the past two years to expand medical home availability and use in the state.

The Minnesota Department of Human Services (DHS) is developing criteria and working with patients and the healthcare community to begin certifying physicians by July 2009. By 2010, the state will begin paying certified medical homes care coordination fees, and while the exact amounts have not been determined, the highest fees will be paid for individuals needing the most care.

In addition, beginning in 2010, all private insurers in Minnesota will be required to pay care coordination fees for their members who receive care from a state certified medical home. Next year, the state will work with the healthcare community to devise a uniform method for calculating payment categories. The formula will group similar kinds of patients together in a hierarchy based on medical complexity so that health plans will all use the same criteria to negotiate care coordination payments.

The Minnesota Department of Health (MDH) and DHS are working on a contract with the Institute for Clinical Systems Improvement (ICSI) to develop recommendations on what the outcomes should be for healthcare homes. ICSI’s final recommendations as well as a report on the “state of the art” of health care homes were both released in January and can be found at

Iowa legislation directed the Iowa Department of Human Services to implant a statewide medical home system. “The first priority will be to get children in the Medicaid program into medical homes,” says Beth Jones, Medical Home Coordinator for the Iowa Department of Public Health. The legislation then directs the state to expand the medical home system to adult Medicaid beneficiaries followed by state employees, and finally by privately insured Iowans. An advisory council made up of state officials, consumers, and representatives from medical associations will oversee the new program.

Other states are making plans or developing models for medical homes and include Colorado, Illinois, Louisiana, Maine, Michigan, New Hampshire, New York, Ohio, Pennsylvania, Rhode Island, Tennessee, and Texas.