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The patient-centered medical home (PCMH) is a method to deliver and organize healthcare that helps to improve the patient’s experience of care, improve the health of populations, and reduce or control the costs of healthcare. The PCMH model allows the primary care physician and the patient to be in the center of the healthcare system, to know what is going on and help the patient be in control of their health.
Practices in the PCMH program will have a Primary Care Representative to guide them through the PCMH process. Practices will have access to PCMH resources, webinars and training throughout the year. The Primary Care Representative will be available to answer questions, provide feedback or make site visits as necessary to help practices be successful.
There are two financial components to support Practices, care management fees and a performance based incentive payment. Care management fees are calculated on a per member per month (PMPM) basis for all fully insured plans and some self-insured plans. The performance based incentive payment (PBIP) began with the 2020 program year and is calculated on quality metrics, utilization, and patient experience of care.
The patient-centered medical home provides better care and greater satisfaction to patients, physicians, and the healthcare team by making sure that the patient’s needs are met.