The primary objective of the Center for Multi-Payer Demonstrations (CMD) is to serve as a clearing house for information on Patient-Centered Medical Home (PCMH) pilot efforts around the country that include multiple private sector payers. The CMD will aim to recruit payers to devote covered lives to demonstration projects, while assisting them with demonstrations efforts through sharing of lessons learned and best practices from existing PCMH demonstrations. This will be accomplished by the CMD serving as an information exchange where Plans can discuss innovative reimbursement models to test in pilots as well as program design. The CMD will also be responsible for working with local convening entities to support regional pilots.

 

Through the PCPCC website, the CMD will create an interface that includes the following:

• Information exchange through individual state pages – Plans can post progress and meeting materials from local efforts
• Message Boards – searchable by topic, state effort, stakeholder involvement
• Other?

The CMD will convene and report out at general meetings of the PCPCC progress towards achieving the following goals/objectives:

Short-Term

1. Explore the potential application of local PCMH efforts relating to care coordination, physician office infrastructure development and improved chronic care delivery as being consistent with PCMH demonstration principles.

2. Establish a process where the CMD can quickly move to identify regions that have potential as PCMH demonstration sites. A core set of minimum requirements for what constitutes a PCMH demonstration will be established based on current PCMH demonstration efforts and the NCQA Physician Practice Connections for the Patient-Centered Medical Home tool.

Long-Term

3. Pair local convening entities with payers to identify suitable demonstration sites and outline the framework for how these sites will operate. The primary care societies will also assist with facilitation and program development to support the practices chosen for this demonstration.

4. Explore the potential for electronic connectivity for secure exchange of clinical and administrative data across all payers to be used for ongoing analysis of performance and health care quality improvement.

5. Demonstrate empirically the value of the PCMH demonstrations in changing the manner in which primary care is financed and health outcomes and other important patient outcomes are improved through the use of shared, confidentially maintained data. Lessons learned from the demonstrations will help craft or revise any reimbursement policies moving forward.