Nebraska

In 2009, Legislative Bill 396 authorized the Nebraska Medical Home Pilot Program Act with the purpose of improving health care access and health outcomes for patients and containing costs in the Medicaid program. The act defined medical home for the state of Nebraska and authorized a medical home pilot program. In 2011, the Nebraska Medicaid Patient-Centered Medical Home (PCMH) pilot was launched with two participating primary care practices; the pilot ended in 2013. In 2014, a voluntary, two-year, multi-payer medical home pilot was launched with the support of the Nebraska Legislature through a Participation Agreement. Commercial insurers and Medicaid managed care plans were asked to support PCMH-recognized practices by linking payments to clinical, financial and patient satisfaction measures. The goals of the Agreement include contracting with approximately 10 clinics by the end of 2014 and 20 clinics by the end of 2015.

Primary Care Innovations and PCMH Activity

Dual Eligible 2703 SPA CPC CPC+ PCMH QHP PCMH Legislation Private Payer

Multi-Payer Programs

Program Name Payer Type Coverage Area Parent Program Outcomes
Nebraska Medicaid Multi-Payer Medical Home Pilot Program Multi-Payer Statewide

Private Payer Programs

State Legislation

Legislation Status Year
Legislative Bill 396

The legislation authorized the Nebraska Medical Home Pilot Program Act with the purpose of improving health care access and health outcomes for patients and containing costs in the Medicaid program. The act defined medical home for the state of Nebraska and authorized a two-year medical home pilot program.

Active 2009
Participation Agreement

This Participation Agreement is predicated on LB239 - Adopt the Nebraska All-Payer Patient-Centered Medical Home Act, proposed by Senator Wightman. The voluntary agreement provides an opportunity for insurance companies and providers to agree to support and promote the creation of PCMHs in Nebraska through the use of consistent requirements and measurements. Through their signing of this agreement, insurers in Nebraska must commit to incorporating a payment mechanism that recognizes value beyond fee-for-service payment. The agreement expires in January 2016. 

Active 2014

State Facts:

Population:
1,844,800
Uninsured Population:
10%
Total Medicaid Spending FY 2013: 
$1.8 Billion 
Overweight/Obese Adults:
66%
Poor Mental Health among Adults: 
30.4%
Medicaid Expansion: 
No

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