Nebraska Patient-Centered Medical Home Pilot

Program Location: 
Lexington, NE
Number of Practices: 
Payer Type: 

Reported Outcomes


In 2009, the Nebraska Legislature, through enabling legislation initiated the Nebraska Medical Home Pilot Program Act to be designed and implemented by the Division of Medicaid and Long-Term Care (DHHS). The two-year pilot began in February, 2011, with two rural practices and 7000 Medicaid patients. The focus for the pilot was to transform the two practices into recognized patient-centered medical homes (PCMH) in order to improve health care access and health outcomes for patients and contain costs of the medical assistance program.

A goal of the pilot program was to transform primary practices into fully recognized and operating medical homes that met the criteria of a patientcentered medical home. DHHS reviewed standards utilized in other states along with the national credentialing organization, NCQA, standards. The final standards for Nebraska’s pilot were a hybrid of several models. 

**The pilot concluded February, 2013.

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Payment Model: 

A PMPM was established for patient care coordination and administration expenses. Initially the pilot practices received $2 PMPM and once they achieved the Tier 1 minimum standards, the PMPM was increased to $4. One practice met the minimum standards six months after the start of the pilot and the other practice at nine months. A practice meeting the optional Tier 2 standards received a 5% enhanced fee-for-service payment on office visits. One practice achieved Tier 2 six months prior to the end of the pilot.

Fewer ED / Hospital Visits: 
  • significant decrease in the rate of overall Emergency Room (ER) visits per 1,000 
  • no significant difference in revisits to the ER for the same complaint
  • a slight increase in hospital readmissions, yet noticeable reduction in proportion of all admissions that were caused by ambulatory care sensitive conditions tracked in this pilot
Improved Health: 
  • distinct improvement in patient health outcomes 
Improved Patient/Clinician Satisfaction: 
  • patient indicators suggested an increase in satisfaction with the services provided
  • provider and employee satisfaction fluctuated over the course of the pilot and did not reflect overall significant improvement by the end 
Cost Savings: 
  • small decrease in costs for high-tech radiology 
  • significant decrease in the rate of prescriptions written and spending per 1,000 
  • the increase in rate of spending on specialist visits per 1,000 clients was not statistically significant
  • total expenditures per client per month reflected a slight decrease
Last updated March 2019
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