Alabama
Alabama has active PCMH programs in both the public and private sectors. Since 1997, Alabama Medicaid enrollees have had access to a basic medical home model through Patient 1st, the agency’s Primary Care Case Management Program (PCCM). In 2011, the Patient 1st program added Patient Care Networks of Alabama (PCNAs) to help primary medical providers improve health services delivery and coordinate care. In 2013, SB 340 legislation was passed to build on the existing PCNAs by creating Regional Care Organizations (RCOs) that further manage a continuum of health care services under a single capitated rate.
Primary Care Innovations and PCMH Activity
| Dual Eligible | 2703 SPA | CPC | CPC+ | PCMH QHP | PCMH Legislation | Private Payer |
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Public Payer Programs
| Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
|---|---|---|---|---|
| Alabama Health Homes Program | Medicaid | Statewide | ACA Section 2703 Health Homes |
   
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| Alabama Regional Care Organizations (RCOs) | Medicaid | statewide - 5 regions | ||
| Huntsville Hospital Medical Neighborhood Demonstration - Alabama | Grant | Huntsville | CMS Health Care Innovation Award - PCMN Demonstration | |
| Patient 1st and Patient Care Networks of Alabama (PCNA) | Medicaid | Alabama - Statewide | Medicaid Section 1115 Waiver |
Private Payer Programs
| Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
|---|---|---|---|---|
| BlueCross BlueShield of Alabama Primary Care Value Based Payment Program | Commercial | Alabama - Statewide | Blue Cross Blue Shield Value-Based Care Program |
  
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State Facts:
Population:
4,755,200
Uninsured Population:
16%
Total Medicaid Spending FY 2013:
$5 Billion
Overweight/Obese Adults:
68.2%
Poor Mental Health among Adults:
34.8%
Medicaid Expansion:
No
News and Events
February 6, 2018
February 16, 2016 | Modern Healthcare
August 4, 2015 | AL
June 28, 2015 | Decatur Daily
March 6, 2015 | Alabama Medicaid Agency
October 8, 2014 | The Crimson White
January 13, 2014 | PCPCC Press Release
