Developing Infrastructure and Community Linkages

States are key facilitators when it comes to building community infrastructure to support multi-payer pilots, such as information technology, shared practice supports, and behavioral health integration.


Also see the Supporting Practices section of NASHP’s Medical Home Map and the Support for Infrastructure section of NASHP’s State Accountable Care Activity Map.

  • Community Care of North Carolina. 2013. “CCNC: Community Care of North Carolina.” Care of North Carolina pioneered a model of community network-based practice support on which many states have since built. The statewide program is supported by multiple payers, including Medicare through CMS’s Multi-payer Advanced Primary Care Practice Demonstration, in seven rural North Carolina counties.
  • Maine Quality Counts. 2013. “Maine Patient-Centered Medical Home Pilot – Community Care Teams.”’s multi-payer patient-centered medical home pilot features multi-disciplinary community care teams to support practices, act as a link to behavioral health providers and social workers, and connect patients with community resources. The state launched two additional community care teams in January 2013, selected through a Request for Proposals process.
  • Kaye, Neva, Jason Buxbaum, and Mary Takach. 2011. “Building Medical Homes: Lessons from Eight States with Emerging Programs.” National Academy for State Health Policy.Describes state strategies for supporting practices in medical home transformation, including infrastructure development such as health information technology and shared practice supports like community care teams or networks (see pg. 14).
  • Kaye, Neva, and Mary Takach. 2009. “Building Medical Homes in State Medicaid and CHIP Programs.” National Academy for State Health Policy.Discusses state policies to support primary care through external and infrastructure development, including community care teams or networks, health information exchanges, and patient engagement (see pg. 31).



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