HARTFORD, Conn. – More than two years ago, Connecticut launched a patient-centered medical home model for its Medicaid population. It’s a model where a patient relies upon their primary care physician to coordinate all of their care and actively remind them about preventive screenings or exams.
The idea behind the model and the payment method was to increase access and lower the amount of money the system pays to treat these patients by improving their health outcomes and keeping chronic conditions under control.
In order for a physician’s office to receive a higher reimbursement for these patients they have to meet or prove that they are on a path to meet standards set forth by the National Committee for Quality Assurance (NCQA). There are about 1,193 providers serving more than 250,000 Medicaid patients who are qualified to receive these higher reimbursements. It costs a practice of about five physicians $2,500 a year to maintain their certification.
Advocates say that’s a small price to pay for the additional $150,000 the average practice receives in higher reimbursements for managing the care of their Medicaid patients.