Person-Centered Medical Home Plus or PCMH+ provides person-centered, comprehensive and coordinated care to HUSKY members. The purpose of this webpage is to provide PCMH+ Participating Entities with program information and updates.
If you are PCMH+ HUSKY Member and have questions about your provider, or questions about your care, please call 1-800-859-9889. The HUSKY Health Program Covered Services guide is also available and features information about covered HUSKY services.
PCMH+ Program Information and Updates
January 9, 2017 - Request for Proposals (RFP) for PCMH+ Wave 2
The Department of Social Services requests proposals for PCMH+ Wave 2. Read the RFP for full details.
PCMH+ Wave 2 aims to continue to improve health outcomes and the care experience of Medicaid members and to contain the growth of health care costs. Selected FQHCs and Advanced Networks will provide care coordination to improve the quality, efficiency, and effectiveness of care delivered to Medicaid members. If a PCMH+ Participating Entity meets specified quality standards and generates savings for Medicaid, that entity will receive a shared savings payment. FQHC Participating Entities will also receive a monthly Care Coordination Add-On Payment.
IMPORTANT NOTE: All Participating Entities (both Advanced Networks and FQHCs) that participated in PCMH+ Program, Wave 1, will be rolled over into participation in the PCMH+ Wave 2, for a project period beginning April 1, 2018 and running through December 31, 2019, without being required to respond to this RFP, so long as they comply with all applicable requirements of PCMH+ Wave 2, comply with all requirements contained within the RFP, and have notified the Department of their intent to participate in PCMH+ Wave 2 in accordance with the terms of the amendment to their contract for PCMH+ Wave 1.
December 19, 2017 - Update on PCMH+ Wave 2
The Department of Social Services (DSS) remains strongly committed to the success of the Person-Centered Medical Home Plus (PCMH+) program.
In support of that commitment, Participating Entities (PEs) currently participating in PCMH+ Wave 1 will be offered a three-month extension to their current contract, which will run until March 31, 2018. Per member per month (PMPM) payments to Wave 1 FQHCs will continue from January to March using the current Wave 1 member assignment.
The Wave 2 RFP will maintain the requirement that applicants serve a minimum of 2,500 attributed PCMH+ eligible members and will maintain the $4.50 PMPM payment to all current FQHCs and any new FQHCs selected through the procurement process. Due to state budget constraints, PMPM payments will remain limited to FQHCs. However, both current and new Advanced Networks may apply for grant funding through the State Innovation Model (SIM) transformation awards.
To remain consistent with national quality measure results and facilitate comparisons for shared savings calculations, the following timeline applies for PCMH+ Wave 2:
- Quality measures and all other measures used in the shared savings calculation will be based on the full calendar year 2018 (January 1, 2018 - December 31, 2018).
- PCMH+ Wave 2 start date is April 1, 2018.
- Wave 2 PCMH+ member assignment lists will be distributed on or about April 1, 2018 (based on an attribution from March 2018).
- Wave 2 PMPM payments to FQHCs will begin for the month of April 2018 using the attribution analyzed from March 2018.
Those PEs currently participating in PCMH+ Wave 1, that are in good standing, will NOT be required to submit a response to the Wave 2 RFP and will be automatically offered the right to enter into a contract amendment to be designated as a PE for PCMH+ Wave 2. Such offer is wholly contingent upon the PEs agreement to comply with all of the requirements for PCMH+ Wave 2.
August 8, 2017 - 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.