SIMPMO: Advanced Medical Home Program CT State Innovation Model Program Management Office SIMPMO: Advanced Medical Home Program


{Advanced Medical Home}


Application Opens for Advanced Medical Home Program

AMH Conference December 8, 2016

About the Advanced Medical Home Program


Application Opens for Advanced Medical Home Program


{Video: What}

Video: What's the Benefit of AMH/PCMH?

The SIM Office has opened the application for the Advanced Medical Home Program. This support will help primary care practices within Advanced Networks to become a patient-centered medical home by obtaining the Advanced Medical Home designation, which includes NCQA PCMH 2017 recognition with added emphasis on person-centered care and health equity. Selected applicants will receive free technical assistance, including on-site visits, webinars, and peer-to-peer learning.


Being a patient-centered medical home helps care teams meet the new challenges and opportunities of today's healthcare system. The program focuses on enhancing clinician and staff satisfaction, improving patient outcomes, and maintaining a supportive and team-based workplace.


Transforming into a patient-centered medical home has many benefits in Connecticut, such as increasing practices' ability to succeed in new care delivery and payment models. This includes Medicare's new Quality Payment Program (also known as MACRA or MIPS), where being a PCMH helps you meet 100% of the possible points in the practice improvement component. Being a PCMH is also an eligibility requirement for Medicaid's Shared Savings Program (PCMH+).


The SIM Office seeks to recruit 150 practices into the program by December 20, 2016, 3pm. Apply soon since the application period may close early, depending on when we reach our recruitment target.


The RFA and additional information can be found at the DAS State Contracting Portal


AMH Program Components and Technology Requirements


AMH Conference - December 8, 2016

{Advanced Medical Home Conference Panel}

On December 8th, the SIM initiative brought together over a hundred healthcare providers, administrators, and practice staff to hear about why it has never been a better time to become a patient-centered medical home (PCMH). Alice Ferguson (far right), patient advocate and member of the SIM Consumer Advisory Board, shared her challenges as a person with a serious health condition trying to navigate the uncoordinated health system. Team-based care and communication, key tenants of a medical home, were critical to achieving her goals for recovery. Read more about the other speakers here.


Click Here for Conference Presentations

About the AMH Program


Advanced Medical Home Program At A Glance

Current AMH Vanguard Enrollees


A cornerstone of our Innovation Plan is supporting the transformation of primary care to the Advanced Medical Home (AMH), a care delivery model comprising five core elements:


{Advanced Medical Home Glide Path} Whole-person-centered care: care that addresses the full array of medical, social, behavioral health, oral health, cultural, environmental, and socioeconomic factors that contribute to a consumer's ongoing health.


Enhanced access: an array of improvements in access including expanded provider hours and same-day appointments; e-consult access to specialists; non-visit methods for accessing the primary care team; clear, easily accessible information; and care that is convenient, timely, and linguistically and culturally appropriate.


Population health management: use of population-based data to understand practice sub-populations (e.g., race/ethnicity), panel and individual patient risk, and to inform care coordination and continuous quality improvement, and to determine which AMHs are impacting health disparities, for which conditions and for which populations.


Team-based coordinated care: multi-disciplinary teams offering integrated care from primary care providers, specialists, and other health professionals. An essential element in what makes this work is the combination of behavioral healthcare with medical care, whether through co-location, referral linkages, or as part of a virtual team.


Evidence-informed clinical decision making: applying clinical evidence to healthcare decisions using electronic health record (EHR) decision support, shared decision making tools, and provider quality and cost data at the point-of-care to enable consumer directed care decisions.


Content Last Modified on 2/15/2017 3:52:49 PM