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Financing the Patient-Centered Medical Home: Making the Investment in Primary Care Sandeep Wadhwa, MD, MBA Medicaid Di

Colorado Health Care Snapshot. Source of Insurance Numbers in Thousands

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Financing the Patient-Centered Medical Home: Making the Investment in Primary Care Sandeep Wadhwa, MD, MBA Medicaid Di

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    1. Financing the Patient-Centered Medical Home: Making the Investment in Primary Care Sandeep Wadhwa, MD, MBA Medicaid Director and Chief Medical Officer State of Colorado October 2008

    2. Colorado Health Care Snapshot

    3. Medical Services Premiums Caseload FY 07-08 ADD ACTUAL CASELOAD NUMBERS DOWN HEREADD ACTUAL CASELOAD NUMBERS DOWN HERE

    4. Medical Services Premiums Per Capita Cost FY 07-08

    5. State’s Role in Primary Care Reform Legislative/regulatory authority Catalyst for encouraging public/private collaboration Active participant in the community of payers Dominant payer for safety net Presentations are available on-linePresentations are available on-line

    6. Financing Primary Care Reform Medicaid - Phase 1 Repurposed our EPSDT care coordinators to support Medical Home objectives Increased EPSDT payments to further cover Medical Home activities Regional ASO with 50% shared savings with primary care physicians Presentations are available on-linePresentations are available on-line

    7. Financing Primary Care Reform Medicaid - Phase 2 Care management PMPM fee for medical home providers Care coordinator and health educator layer - community and office based Move from shared savings to shared outcome incentives (ambulatory care sensitive conditions hospitalizations, emergency room visits) Presentations are available on-linePresentations are available on-line

    8. State Based Primary Care Reform Participate in multi-payer collaborative Created public-private value- based healthcare center to collaboratively address structuring/financing of primary care Presentations are available on-linePresentations are available on-line

    9. Thank you Sandeep Wadhwa, MD sandeep.wadhwa@state.co.us

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