The Department of Health Services is working closely with the Centers for Medicare and Medicaid Services (CMS) on a waiver to provide all childless adults under 100% FPL with Medicaid for the first time in the state’s history. This bolstering of the state’s safety net will provide nearly 100,000 Wisconsin residents who live in poverty with health care under the state’s Standard Medicaid benefit. In March 2013, then Secretary-Elect, Kitty Rhoades, gave testimony to the Joint Committee on Finance in which she stated that as part of her responsible management of the Medicaid program, she will include medical homes as a model to reform service delivery for Medicaid beneficiaries  The Wisconsin Department of Health Services's State Plan Amendment (SPA) for their Section 2703 Heatlh Home program, named Behavioral Health Integrated Care (BHIC) was approved initially for patients with HIV/AIDS and children in foster care. The BHIC health home will focus on preventive services, wellness, and chronic and acute care for both behavioral and physical health needs. The BHIC will provide additional care coordination and care management resources and access to dental services for the eligible population. 

Funded by the Children's Hospital of Wisconsin and the Wisconsin Department of Health Services, Division of Public Health, Children and Youth with Special Health Care Needs Program, the Wisconsin Statewide Medical Home Initiative (WiSMHI)  works to promote the concepts of medical home for primary care clinicians, families, and service providers throughout the state. Training, technical assistance and resources are provided to support medical home implementation with a focus in the areas of early identification of developmental concerns in the primary care practice and coordination of care and services including those for youth with special health care needs.

Primary Care Innovations and PCMH Activity

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

Private Payer Programs

Program Name Payer Type Coverage Area Parent Program Outcomes
Enhanced Personal Health Care Program - Wisconsin Commercial Northeast and Southeast Wisconsin Anthem - Enhanced Personal Health Care
Humana medical home program - Prevea Clinic Commercial Green Bay Humana Medical Home Program

State Facts:

Uninsured Population:
Total Medicaid Spending FY 2013: 
$7.1 Billion 
Overweight/Obese Adults:
Poor Mental Health among Adults: 
Medicaid Expansion: 

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