NH Multi-Stakeholder Medical Home Pilot

Region Within State: 
Statewide
Project Category: 
Insurer-Based
PROJECT STATUS
Target Start Date: 
Thursday, January 1, 2009
Pilot/Demo Length: 
2-3 years

The goal of the NH Multi-Stakeholder Medical Home Pilot is to prescribe, value and reward medical care that is tightly coordinated, patient-centered, and of superior quality and efficiency. Our research questions are as follows: • If payers and providers make the investment in PCMHs, can it create value (as defined by cost savings or higher quality of care)? • Will there be sufficient value created to cover costs of investment? and • What are the metrics that are best correlated to value creation? Our focus is on the adult populations in primary care settings that range from rural to urban populations and in independent, hospital-owned, and community health center practices.

CONVENING ENTITY/PROJECT CONTACTS
Convening Organization Name: 
Convening Organization Name: New Hampshire Citizens Health Initiative
Primary Contact: 
Heather Staples
E-mail: 
[email protected]
Phone: 
603/491-2701
Additional Contact
Name: 
Ned Helms
Phone: 
603/862-5030
Participating Stakeholders: 

NH Citizens Health Initiative; Anthem Blue Cross Blue Shield of NH; Cigna Health Care of NH; Harvard Pilgrim Health Care; MVP Healthcare; NH Medicaid; Center for Medical Home Improvement; NH Institute for Health Policy and Practice; Dartmouth Hitchcock Medical Center; Ammonoosuc Community Health Services; Concord Hospital Health Center; Dartmouth Hitchcock Medical Center Keene; Derry Medical Center; Elliot Family Medicine at Bedford Commons; Lamprey Health Care; Life Long Care; Mid-State Health Center; Westside Healthcare/LRGH.

EXPECTED OR ACTUAL DEMOGRAPHICS OF PARTICIPATING PRACTICES
Number of Practices: 
9
Number of Participating Physicians: 
63
Physicians per practice: 
2-17
Types of Practices: 
Internal Medicine, Family Medicine
Health Plan Lines of Business Included: 
Commercial
Overall Number of Covered Lives: 
39000
Technology Characteristics at Start of Pilot: 

Estimated % of practices with practice management systems: >95%
Estimated % of practices with electronic medical record: >95%
Estimated % of practices with registry software: 76-95%
Other: 100% of sites have electronic prescribing 100% of sites import emergency room, hospital, lab, and radiology data into the medical record 60% communicate with patients using email 60% can view prescription information through a patient portal 33% have a personal health record 67% have an electronic care plan

PRACTICE TRANSFORMATION SUPPORT (INCLUDING TECHNOLOGY)
Technology that participating practices have added as a result of their participation: 

Sites have added registry functions, care coordinators, and other staff members.

Payment Model: 

The sites are paid a prospective per member per month fee that increases with NCQA Recognition Level. The recommended mid-point, across all PCMH Recognition Levels is $4 pmpm. The fee is paid directly by the participating carriers every six months for adult members in the practice. The carriers additionally have included their existing pay for performance programs for improvements in quality and cost.

PROJECT EVALUATION
Types of data to be collected : 

Clinical Quality Cost/Efficiency Patient Experience/Satisfaction Provider Experience/Satisfaction

Which of the data types are being shared?: 

Clinical, quality, and performance data.

Are the practices involved in the demonstration participating in any data sharing arrangements? If so please describe.: 

Yes, Health insurance providers involved in the demonstration

Pilot Link: 
NH Citizens Health Initiative
Center for Medical Home Improvement