Forum Session

Building the Medical Home: Under Construction in the States
June 5, 2009


Lisa Sprague, MBA


Promoting adoption of the medical home model remains a central theme in health reform discussions. The concept is wielded to serve a number of policy aims, from shoring up primary care practice to coordinating care for patients with multiple complex chronic conditions to encouraging more widespread use of health information technology as a vehicle for delivery system transformation.

Whether a single model can successfully serve such disparate goals is still an open question. One place to explore that question is in state Medicaid programs, which serve both children (who most often need preventive and primary care, though a subset also have chronic and/or disabling conditions) and an aged/blind/disabled population often in need of complex and continuous care. State Medicaid programs have experience serving a population that frequently needs social as well as clinical services. They have experience with different types of provider structures and various forms of care management. They have experimented with reimbursement approaches designed to promote participation and quality improvement among providers.

This Forum session, the third in a series examining PCMH programs, brought together representatives from four states who are engaged in implementing such programs, who talked about their efforts to transform the way care is delivered as they gradually bring in more complex populations and test new ways to influence provider behavior.


Mary Takach, Policy Specialist, National Academy for State Health Policy; Joan Henneberry, Executive Director, Department of Health Care Policy and Financing; Christopher G. Atchison, Associate Dean, College of Public Health, University of Iowa; Anthony Rodgers, Director, Arizona Health Care Cost Containment System; Jeffrey Schiff, MD, Medical Director, Minnesota Health Care Programs

Slides from the presentation by Ms. Takach are available for download. Speakers' biographies are also available.

Related Materials

See also the entries for the related Forum sessions on the medical home model, held June 27, 2008 and October 28, 2008.

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