Person-Centered Medical Home Plus (PCMH+)

Overview

The Department is implementing a new program called Person-Centered Medical Home Plus or PCMH+. PCMH+ will provide person-centered, comprehensive and coordinated care. The purpose of this webpage is to provide PCMH+ Participating Entities with program information and updates.
 
If you are PCMH+ Member and have questions about your provider, or questions about your care, please visit the PCMH+ Member website Opens in a new window or call 1-800-859-9889.
 
The HUSKY Health Program Covered Services guide is available online and features information about covered HUSKY services.
 
 
PCMH+ Program Information and Updates
 
PCMH+ 'Wave 1' Contracts to be Extended
On August 8th, 2017, the Department of Social Services sent this notice to the PCMH+ Participating Entities:
 
The Department of Social Services remains strongly committed to the success of the PCMH+ initiative. Given the current uncertainty around the General Assembly’s adoption of a state budget for the biennium, however, the Department has determined that it is necessary to revisit and revise its original procurement plans for PCMH+ Wave 2. A state budget is needed before the Department can properly plan for, and release, a Request for Proposals for PCMH+ Wave 2. For that reason, the Department will be extending Wave 1 contracts with its current PCMH+ Participating Entities for three months, through March 31, 2018.
 

 
Special Notice to PCMH+ Participating Entities 

Connecticut’s Person-Centered Medical Home-Plus Initiative
Update/June 29, 2017
 
PCMH+ is a State of Connecticut initiative administered by the Department of Social Services that was launched on January 1, 2017.  
 
PCMH+ represents an opportunity for Connecticut Medicaid to build on, but not supplant, its existing and successful Person-Centered Medical Home (PCMH) initiative, through which over 43% of members are being served. While PCMH will remain the foundation of care delivery transformation, PCMH+ is building on PCMH by incorporating additional requirements for care coordination, focusing upon integration of behavioral and physical health care, children with special health care needs, health equity, and competency in care for individuals with disabilities. It also represents the Department's first use of an upside-only "shared savings" approach under which participating providers that meet specified quality standards and generate savings for Medicaid will receive a portion of the savings that are achieved.
 
DSS is very proud of all PCMH+ Participating Entities for committing to build on longstanding support for Medicaid members.
  • All of you are deeply committed to further transforming your practices, beyond being Person-Centered Medical Homes, to make them as receptive and coordinated as possible for the people whom you serve.
  • All of you are working hard to implement important and challenging new features of care coordination, including coordination of medical and behavioral health care, that will continue to improve members' care experience and outcomes.
  • All of you are working together in an active, dynamic, provider-led collaborative that is meeting regularly and diving into the actual day-to-day practice of how to support people with complex needs.
  • All of you are using extensive Medicaid data, provided by the Community Health Network, Inc. (CHN-CT) through the PCMH portal,  to advance evidence-based practices and, most important, to identify and fill members’ gaps in care.
  • All of you are coordinating with CHNCT on transition of people who previously received CHN-CT Intensive Care Management.
  • All of you are working, as is DSS, with helping Medicaid members to retain eligibility, to understand their covered benefits, and to help them coordinate the full range of their health needs.
DSS is proud of the process that the state has observed in developing PCMH+. We have participated in countless meetings and work groups and webinars on model design with the General Assembly's Medical Assistance Program Oversight Council Care Management Committee. DSS also reported extensively on PCMH+ to the State Innovation Model (SIM) Steering Committee. Collectively, we have carefully listened to, and incorporated many aspects of the feedback that we have received from advocates. The entire process is carefully documented on the MAPOC website Opens in a new window Opens in a new window Opens in a new window Opens in a new window.
 
Finally, we believe that this program deserves to have the opportunity to flourish. The public doesn't have to wonder how you are doing in your work. You are submitting detailed monthly reports to document the intense effort and learning in which you are involved. These reports are all being posted publicly on this dedicated web page. Further, DSS has signaled exactly how the program will be monitored, using a range of tools including claims Opens in a new window Opens in a new window Opens in a new window Opens in a new window.
 
We agree that accountability is extremely important in this ambitious new program. But equally important is attention to facts and experience. We are confident that the record speaks directly to a strong positive launch of PCMH+, and a great deal of potential for good on behalf of Medicaid members. We are also proud of the open, public, collaborative process used to develop PCMH+ and that is being used to conduct the initiative. We will continue to encourage everyone involved to get to know, and monitor, our collective progress.
 
Thank you!
 
Kate McEvoy, Director, Division of Health Services
Dr. Rob Zavoski, Medical Director, Division of Health Services