Skip to main content

Study details cost cutting successes in Medicaid, CHIP medical homes

By Diana Manos

A Commonwealth Fund study shows how Medicaid and State Children's Health Insurance Programs have found ways to build medical homes to cut costs and improve care.

According to the study, as many states grapple with growth in healthcare costs, they're looking at innovative solutions that seek to transform the healthcare delivery system through medical homes.

The study outlines lessons learned by North Carolina Medicaid and a smaller number of programs that have shown that the provision of good, comprehensive primary care through medical homes has helped to improve quality of care and cut costs. Researchers said it will take time to validate these findings in other states and programs.

Since 2006 more than 30 states have developed policies to improve Medicaid and CHIP to advance medical homes. The new CWF report, based on information gathered through the  National Academy for State Health Policy, found 10 states with well-developed medical home initiatives.

Researchers identified five major strategies that formed their success:

  • Partnerships with key players, including patients, providers and private sector payers, whose practices the state seeks to change.
  • Defining medical homes to help establish provider expectations and implementing processes to recognize primary care practices that meet those expectations.
  • Aligning reimbursement and purchasing to support and reward practices that meet performance expectations.
  • Supporting practices to help advance patient-centered care.
  • Measuring results to assess whether their efforts are succeeding in containing costs and improving the quality of care and patient experiences. 

Researchers based their information on interviews with state officials in Colorado, Idaho, Louisiana, Minnesota, New Hampshire, Oklahoma, Oregon, Washington, North Carolina and Rhode Island.