tomlinson- Virginia's Medicaid medical home pilot

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Bryan Tomlinson, MPH, Director, Division of Health Care Services, Virginia Department of Medical Assistance Services discusses Virginia's Medicaid medical home pilot project.

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tomlinson- Virginia's Medicaid medical home pilot

  1. 1. Virginia Medicaid’s Medical Home PilotOrigin: Recognition that PCCM program provides minimal coordinatedcare & focus on outcomes; need for delivery system designed toimprove quality of care among a medically underserved population.Key Partnerships: Southwest Virginia Community Health Systems (an FQHC) -- includes six facilities in far southwest Community Care Network of Virginia CarilionPilot Elements: Recognition or certification standards Practice coaching Care coordinators Information sharing Health information technology (HIT ) Reimbursement methodologyTentative start date: 2011 (for 2 year duration) 1
  2. 2. Other Partners/Stakeholders to Engage Providers/Provider Associations Hospital and Healthcare Association Virginia American Academy of Family Physicians (AAFP) and American Academy of Pediatrics (AAP) chapters Payers Anthem Consumers Community Service Boards Foundations Virginia Healthcare Foundation Legislative champions 2
  3. 3. Lessons Learned/ChallengesInvolve stakeholders early in the processand identify each group’s contributionup-front.The stakeholders in each state’s medicalhome projects differ based on programdesign and budget constraints.Difficult and time consuming processwithout legislative mandate, designatedstaffing and financial resources. 3

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