Delaware Medical Home Pilot

Program Location: 
Dover, DE
Number of Practices: 
Payer Type: 
Partner Organizations: 
Medical Society of Delaware
Highmark Blue Cross Blue Shield Delaware

Delaware's first state-wide patient centered medical home pilot is a multi-stakeholder initiative designed and launched through a partnership between the Medical Society of Delaware and Highmark Delaware. The Initiative is comprised of a multi-stakeholder leadership team, a physician advisory committee of statewide physician leaders and officials from each of the primary care specialty societies, and a management work group. The pilot launched in May 2012 and is slated to run through 2015. 

During the first year of the program, practices become educated on the core components of a medical home and utilize resources to enhance practice readiness for PCMH transformation.  Quality Improvement Coaches are hired to assist many of the pilot practices with the PCMH transformation process.  In years two and three, practices are expected to meet certain benchmarks of both clinical and administrative criteria to remain in the program. The PCMH clinical criteria is based mainly upon HEDIS and preventive measures while the administrative criteria is based upon use of health information technology, reaching PCMH certification via NCQA and other items specific to the health plan. 

Payment Model: 

All three years of the pilot provide enhanced payments to participating practices. In years two and three, additional bonuses may be given to practices that meet certain criteria benchmarks or NCQA PCMH certification.

Last updated August 2015
Go to top