taft-New Tactics for Building Medical Homes in State Medicaid in Nebraska

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Patricia (Pat) Taft, Program Specialist, Division of Medicaid and Long-Term Care, Nebraska Department of Health and Human Services discusses Nebraska's Medical Home Medicaid Pilot at webinar New Tactics for Building Medical Homes in State Medicaid and CHIP Programs on December 16, 2010

Published in: Health & Medicine
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taft-New Tactics for Building Medical Homes in State Medicaid in Nebraska

  1. 1. Nebraska Medicaid Medical Home Pilot• Legislative initiative: 2 year pilot• 2 practices in rural Nebraska• Outcomes: improved  access, health outcomes, cost  containment and measure of patient and  provider satisfaction• Standards: Two tiers • Support: TA through TransforMED + Care    Coordinator staff + patient registry http://www.dhhs.ne.gov/med/Pilot/index.htm 1
  2. 2. Payment Methodology• FFS for all allowable Medicaid services• Initial $2 PMPM; increase to $4 when meet  Tier 1 Minimum Standards• (optional) 5% enhanced FFS on office visits  when meet Tier 2 Advanced Standards• Shared savings and pay‐for‐performance (P4P)  – not feasible 2
  3. 3. Lessons Learned• Active Advisory Council  of physicians  as  champions  – PRICELESS Anticipated challenges• Limitations in Medicaid Management  Information System (MMIS) system• Timely claims for ongoing data  • Evaluating the pilot• Achieving cost neutrality, at a minimum 3

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