Nebraska Medicaid Program

Medicaid Medical Home Pilot Progress

The design of the Nebraska Medicaid Patient-Centered Medical Home Pilot is a collaboration between the Medical Home Advisory Council and the Nebraska Department of Health and Human Services. As progress is made, additional information will be posted to this page.

Pilot Outcomes: There will be an evaluation of the pilot for these outcomes:

  1. Improve health care access
  2. Improve health outcomes for patients
  3. Contain costs in the Medicaid program
  4. Measure patient satisfaction
  5. Measure practice satisfaction

PDF Patient Experience Survey Data

PDF Practice Core Competencies and Standards: Practices participating in the pilot will demonstrate five core competencies and will be expected to meet specific standards to be recognized as a medical home.

PDF Payment Methodology: Practices participating in the pilot will be reimbursed for all allowable Medicaid services and receive an initial per-member-per-month (PMPM) payment. The PMPM will be increased once the practice has met Tier 1 Minimum Standards. Practices will have the option to meet Tier 2 Advanced Standards to receive an enhanced fee-for-service on selected procedure codes.

Pilot Practice Selection Process: The Department published a Request for Information soliciting interested practices. These practices were selected to participate in the pilot:

Kearney Clinic, P.C., Kearney www.kearneyclinic.com/
    KHAS-TV News Report
Plum Creek Medical Group, P.C., Lexington www.pcmed.biz

CMS Authority: Nebraska submitted a PDF Medicaid State Plan Amendment to the Centers for Medicare and Medicaid (CMS) for authority to implement the medical home pilot. This was approved effective 2-1-11.

PDF News Release


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