South Dakota
In 2011, the South Dakota Governor's Office established the Medicaid Solutions Work Group with the goal to solicit input and develop strategies with key stakeholders to contain and control Medicaid costs. Recommendations that emerged from this work group included:
- Re‐design the primary care delivery system to change the way care is delivered and financed.
- Improve care management for high‐cost individuals (including individuals with chronic conditions and pregnant women).
- Address the inappropriate utilization of emergency department services.
- Foster consumer accountability.
- Encourage the appropriate utilization of less costly home and community‐based services.
- Reduce pharmacy costs while maintaining access and quality.
- Implement targeted benefit reductions.
In 2012, a Health Home Work Group designed their state plan amendment for a Section 2703 Health Home program, which was approved by CMS in November 2013.
Primary Care Innovations and PCMH Activity
| Dual Eligible | 2703 SPA | CPC | CPC+ | PCMH QHP | PCMH Legislation | Private Payer |
|---|---|---|---|---|---|---|
 |
 |
|
|
|
|
Public Payer Programs
| Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
|---|---|---|---|---|
| CMS Health Care Innovation Award - Sanford Health South Dakota | Grant | South Dakota, North Dakota and Minnesota | CMS Health Care Innovation Award (Round 1) | |
| South Dakota Health Homes | Medicaid | Statewide | ACA Section 2703 Health Homes |
   
  |
Private Payer Programs
| Program Name | Payer Type | Coverage Area | Parent Program | Outcomes |
|---|---|---|---|---|
| Humana medical home program - Regional Health | Commercial | Rapid City | Humana Medical Home Program |
|
State Facts:
Population:
835,800
Uninsured Population:
9%
Total Medicaid Spending FY 2013:
$766,382,971
Overweight/Obese Adults:
67.0%
Poor Mental Health among Adults:
26.8%
Medicaid Expansion:
No
