Alaska – Medical Homes

In May 2014, Alaska DHSS, the Alaska Primary Care Association, and the Alaska Mental Health Trust Authority launched the Alaska Patient-Centered Medical Home Initiative (AK-PCMH-I), a patient-centered medical home pilot focused on achieving better health outcomes and patient experience for rural and frontier populations. NASHP provided technical assistance to the project team through a Medicaid-Safety Net Learning Collaborative, funded through a federal Health Resources and Services Administration (HRSA) cooperative agreement.

AK-PCMH-I provides grant funding and practice transformation support to five practices in the state, selected through a Request for Proposals (RFP) process. The project is funded in part by a capital grant from the Alaska State Legislature, allocated to the Alaska Primary Care Association in 2012 to support the transformation of a cohort of federally-funded community health centers into medical homes; these funds are supplemented with funding from Alaska DHSS and the Alaska Mental Health Trust Authority.

Alaska’s Department of Health and Social Services (DHSS) Division of Health Care Services medical home work focuses in particular on rural/frontier, tribal, independent and non-rural providers. In early 2012, the state contracted with Public Consulting Group, a national firm, to develop a strategy to advance medical homes in the state.

Federal Support: Alaska is also participating in the Tri-State Child Health Improvement Consortium (T-CHIC), a CHIPRA Quality Demonstration Project funded by the Centers for Medicare & Medicaid Services (CMS), in collaboration with Oregon and West Virginia. Through this project, the state is working to develop medical homes for children enrolled in Alaska Medicaid and Denali Kid Care as a way to increase access to EPSDT services. T-CHIC funding ends in 2015.

Last Updated: June 2014

Forming Partnerships
Defining & Recognizing a Medical Home
Definition: A 2011 Department of Health and Social Services (DHSS) Medicaid Task Force report offers the following definition: “The medical home: (1) puts the patient at the center of their health care decisions, (2) makes it easier for patients to get care and advice when they need it, (3) provides the right care at the right time and eliminates unnecessary procedures, (4) improves health outcomes, (5) coordinates care across multiple providers, and (6) partners patients with their own team of primary care providers.”
 
Recognition: Within 18 months of pilot launch, participating practices must achieve medical home accreditation or recognition under one of three national programs – NCQA PPC PCMH, Joint Commission, or Accreditation Association for Ambulatory Health Care (AAAHC).
In addition to the recognition requirements described above, the practice selection process favored sites that had a focus on behavioral health integration and mature health information technology capacity.
The AK-PCMH-I Request for Proposals (RFP) also identifies five core medical home competencies:
  1. Facilitate ongoing provider-patient relationship
  2. Coordinate continuous patient centered care
  3. Provide highly accessible medical home services
  4. Reduce unnecessary healthcare spending, reduce waste, and improve cost-effectiveness of the health care services
  5. Take part in a quality improvement process
Aligning Reimbursement & Purchasing
The Alaska Patient-Centered Medical Home Initiative (AK-PCMH-I) pilot sites will receive a one-time grant of up to $75,000 to support practice transformation efforts over the 18-month project budget period. Grants are supported in part by a capital grantfrom the Alaska State Legislature in addition to funds from the Alaska Department of Health and Social Services and Alaska Mental Health Trust Authority.
Supporting Practices
According to the Alaska Patient-Centered Medical Home Initiative (AK-PCMH-I) Request for Proposals (RFP), technical assistance for the project is provided by the Alaska Primary Care Association’s Training and Technical Assistance Department. Pilot practices have access to a number of practice supports, including an initial readiness assessment, group learning sessions, peer learning opportunities, practice coaching sessions, teleconferences and webinars, and networking opportunities. A comprehensive technical assistance schedule is included in the RFP.
Measuring Results
The Alaska Patient-Centered Medical Home Initiative (AK-PCMH-I) will use claims data, provider records, satisfaction surveys, and when available EHR data, to evaluate each pilot site on 5 outcomes:
  1. Improved health care access
  2. Improved health outcomes for patients
  3. Improvements promoting long-term cost savings
  4. Enhanced patient satisfaction
  5. Enhanced practice satisfaction