Virginia

The State of Virginia is undergoing significant reforms to their Medicaid program. As outlined by Secretary Hazel in April 2014, the 1st phase includes implementation of their dual eligibles program, the Commonwealth Coordinated Care Program. The second phase includes "Limited Provider Networks and Medical Homes." These will include creating an agreement with the federal government that allows for limited provider networks would afford Virginia’s MCO’s, health systems, and health care providers to create innovative models of  comprehensive care specific to a region, chronic condition, or co-occurring medical situations that span across physical and mental health. While number of providers may be reduced with a limited network, qualifying beneficiaries could receive higher quality coordinated care through a limited network arrangement.

CHIPRA: 
No
MAPCP: 
No
Dual Eligible: 
Yes
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
No
PCMH in QHP: 
No
Legislative PCMH Initiative: 
No
Private Payer Program: 
Yes
State Facts: 
Population:
8,180,700
Uninsured Population:
11%
Total Medicaid Spending FY 2013: 
$7.3 Billion 
Overweight/Obese Adults:
64.0%
Poor Mental Health among Adults: 
30.1%
Medicaid Expansion: 
No

Improving Health for At-Risk Rural Patients (IHARP)- Carilion New River Valley Medical Center

Carilion New River Valley Medical Center received a CMS Health Care Innovation Award to improve medication therapy management for Medicare and Medicaid beneficiaries and other patients in 23 underserved rural counties in southwest Virginia. Their care delivery model, involving six rural and one urban hospitals and 20 primary care practices, trains pharmacists in transformative care and chronic disease management protocols.

Cigna Collaborative Accountable Care (CAC) Program - Fairfax Family Practice

Cigna's collaboration with Fairfax Family Practice Centers is believed to be the first patient-centered accountable care program in Northern Virginia involving a family medical practice and a health plan. The program will benefit approximately 9,700 individuals covered by a Cigna health plan who receive care from among 100 health care professionals at 12 practice locations.

Cigna Collaborative Accountable Care Program - Bon Secours Medical Group

Cigna and the Bon Secours Medical Group, the physician practice group of Bon Secours Virginia Health System, have launched an accountable care initiative to expand patient access to health care, improve care coordination, and achieve the “triple aim” of improving health outcomes, lowering medical costs and increasing patient satisfaction. Known as collaborative accountable care, the program is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs

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