Virginia

CareFirst BlueCross BlueShield announced that the second-year of its PCMH program, one of the nation’s earliest and largest, demonstrated $98 million less in health care costs for its 1 million members. To support its PCMH program, the program facilitates implementation of care plans directed by primary care physicians with the support of local care coordination teams led by RN care coordinators. The care coordinators arrange for and track the care of those members who are at highest risk or who would benefit most from a comprehensive care plan.

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

CMS signed a Memorandum of Understanding with the state of Virginia on 5/21/2014. Commonwealth Coordinated Care is a new initiative to coordinate care for individuals who are currently served by both Medicare and Medicaid and meet certain eligibility requirements.

Cigna and Loudoun Medical Group , one of the largest and most diverse physician-owned, multi-specialty group practices in Virginia, have launched a collaborative accountable care initiative to improve patient access to health care, enhance care coordination, and achieve the “triple aim”of improved health, affordability and patient experience. The program became effective October 1, 2013.