Five Key Strategies to Engage Health Care Payers and Purchasers in a Multi-Payer Medical Home Initative

State Health Policy Briefing

Since 2006, a majority of states have implemented medical home initiatives in their Medicaid and Children’s Health Insurance Programs as a means of containing cost, improving health outcomes, and increasing both patient and provider satisfaction. A medical home is designed to provide team-based care—led by a primary care provider—that is comprehensive, patient-centric, coordinated, assessable, and committed to quality and safety. Many national health plans, including WellPoint, Aetna, Humana, UnitedHealth Group, and Blue Cross Blue Shield, have also embraced the patientcentered medical home model over the past few years. Eighteen 
states are participating in one or more multi-payer medical home initiatives in conjunction with other public and private payers and purchasers, and Medicare has currently joined Medicaid as a payer in 15 different multi-payer initiatives.

Securing payer and purchaser participation—both public and private—is one of the most critical and challenging aspects of implementing a multi-payer medical home initiative. This brief summarizes five overarching strategies that states or other conveners can use to engage additional payers and purchasers in a new or existing 
multi-payer medical home program. Most of the approaches identified in this issue brief have been successfully applied in one or more existing multi-payer initiatives; novel or underutilized strategies identified by state and national experts are also discussed.

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