Person-Centered Medical Home Plus (PCMH+)--Documents

Our customers can access benefit and application information, 24/7, at www.connect.ct.govand www.ct.gov/dss/apply;
or 1-855-6-CONNECT (except during system maintenance beginning on Friday, March 13, from 7:00 p.m. to Saturday, March 14, 7:00 p.m.).ADDING SOME TEXT.

Documents

Quick Links:

2016
2017
2018

December 2019 CAHPS Survey and Exhibit

Charter Oak Health Center Report
Charter Oak Health Center Exhibit

Community Health Clinic Report
Community Health Clinic Exhibit

Cornell Scott-Hill Health Center Report
Cornell Scott-Hill Health Center Exhibit

Fair Haven Community Health Center Report
Fair Haven Community Health Center Exhibit

First Choice Community Health Center Report
First Choice Community Health Center Exhibit

Generations Family Health Center Report
Generations Family Health Center Exhibit

Hartford Healthcare Medical Group Report
Hartford Healthcare Medical Group Exhibit

Northeast Medical Group Report
Northeast Medical Group Exhibit

Optimus Health Care Report
Optimus Health Care Exhibit

Prospect Medical Report
Prospect Medical Exhibit

Southwest Community Health Center Report
Southwest Community Health Center Exhibit

United Community & Family Services Report
United Community & Family Services Exhibit

St Vincent Report
St Vincent Exhibit

Wheeler Torrington Report
Wheeler Torrington Exhibit

December 4, 2019

Care Management Committee Shared Savings Wave 2, Year 1 Results Webinar
Download the Webinar Presentation

October 2019

PE Collaborative Meeting October 24, 2019
Medication Assisted/Addiction Treatment

September 2019

PCMH+ PE Collaborative Meeting Coordinated Access Networks (CAN) (September 12, 2019)

August 2019

PCMH+ PE Dashboard 2019 First Quarter
PCMH+ Participation Detail - August 2019
PCMH+ Member Complaint Summary - August 2019

July 2019

PCMH+ Participation Detail - July 2019

Participating Entity Monthly* Reports - July 2019
*Only PEs new to Wave 2 are required to submit monthly reports. Legacy PEs are required to submit quarterly reports only.
Participating Entity #1
Participating Entity #5
Participating Entity #7
Participating Entity #10
Participating Entity #14.1
Participating Entity #14.2

PE Collaborative Meeting Resources
Bridgeport Neighborhood Trust Housing Resources
Bridgeport Neighborhood Trust Housing Counseling
Medicaid Supportive Housing Benefit (MAPOC 6/14/19 presentation)
CT Association for Human Services - Program Guide Book (English)
CT Association for Human Services - Program Guide Book (Spanish)

June 2019

May 2019

Year-Three Quality Measure Benchmarks
PCMH+ Participation Detail - May 2019
PCMH+ Member Complaint Summary

2019 Compliance Review Report - First Choice Health Center
2019 Compliance Review Report - Hartford Healthcare Medical Group
2019 Compliance Review Report - Prospect Medical Foundation
Prospect Medical Foundation Response Letter
2019 Compliance Review Report - United Community and Family Services
2019 Compliance Review Report - Wheeler Torrington Advanced Network
Torrington Response Letter
Wheeler Response Letter

Participating Entity Monthly* Reports - May 2019
*Only PEs new to Wave 2 are required to submit monthly reports. Legacy PEs are required to submit quarterly reports only.
Participating Entity #1
Participating Entity #3
Participating Entity #5
Participating Entity #7
Participating Entity #10
Participating Entity #14.1
Participating Entity #14.2

April 2019

PCMH+ Participation Detail - April 2019
PCMH+ Member Complaint Summary

Participating Entity Monthly/Quarterly Reports - April 2019
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9
Participating Entity #10
Participating Entity #11
Participating Entity #12
Participating Entity #14.1
Participating Entity #14.2

March 2019

PCMH+ Participation Detail - March 2019
PCMH+ Member Complaint Summary

Participating Entity Monthly* Reports - March 2019
*Only PEs new to Wave 2 are required to submit monthly reports. Legacy PEs are required to submit quarterly reports only.
Participating Entity #1
Participating Entity #3
Participating Entity #5
Participating Entity #10
Participating Entity #14

February 2019

PCMH+ Shared Savings Calculations Results - Corrected Results
PCMH+ Wave 1 Challenge Pool Distribution - Corrected distribution of challenge pool awards

PCMH+ Participation Detail - February 2019
PCMH+ Member Complaint Summary

Participating Entity Monthly* Reports - February 2019
*Only PEs new to Wave 2 are required to submit monthly reports. Legacy PEs are required to submit quarterly reports only.
Participating Entity #1
Participating Entity #3
Participating Entity #5
Participating Entity #10
Participating Entity #14

January 2019

2018

December 2018

Medical Assistance Program Oversight Council (MAPOC) December 14, 2018 Meeting
Recorded 12/14/2018 - Discussion by Mercer on error made in their calculation of Wave 1 challenge pool award distribution.
PCMH+ Wave 1 Challenge Pool Distribution - Corrected distribution of challenge pool awards
PCMH+ Wave 1 2016 & 2017 Quality Measure Results (All PEs)

PCMH+ Member Complaint Summary
PCMH+ Participation Detail - April - December 2018

Participating Entity Monthly* Reports - December 2018
*Only PEs new to Wave 2 are required to submit monthly reports. Legacy PEs are required to submit quarterly reports only.
Participating Entity #1
Participating Entity #3
Participating Entity #5
Participating Entity #10
Participating Entity #14

November 2018

Wave 1 Quality Measure Results (presented at Care Management Committee and MAPOC)

Quality Measure Walk-through Webinar Presentation - November 1, 2018
John Hopkins Adjusted Clinical Groups (ACG) and Risk Score Calculation Methodology

October 2018

FQHC PCMH & PCMH+ Member Complaint Summary
PCMH+ Member Complaint Summary
PCMH+ Participation Detail - April to October 2018

October 4 Collaborative Meeting
Shared Savings Calculation Presentation

Participating Entity Monthly* Reports - October 2018
*Only PEs new to Wave 2 are required to submit monthly reports. Legacy PEs are required to submit quarterly reports only.
Participating Entity #1
Participating Entity #3
Participating Entity #5
Participating Entity #10
Participating Entity #14

September 2018

PCMH+ Quality Measure Webinar Presentation (September 19, 2018)
PCMH+ Participation Detail - April to September 2018
FQHC PCMH & PCMH+ Member Complaint Summary - September 2018
PCMH+ Member Complaint Summary - September 2018

Participating Entity Monthly/Quarterly Reports – September 2018
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9 - Pending
Participating Entity #10
Participating Entity #11
Participating Entity #12
Participating Entity #13
Participating Entity #14

August 2018

August 2 Collaborative Meeting Material
PCMH+ August 2 Collaborative Meeting Presentation (CYSHCN and TAY)
CSHCN Screener Tool (example)
CSHCN Screener Fast Facts
TAY with IDD Integration Practice Plan (example)
TAY Sample Letter
TAY Plan of Care (example)
TAY Policy (example)

Participating Entity Monthly* Reports - August 2018
*Only PEs new to Wave 2 are required to submit monthly reports. Legacy PEs are required to submit quarterly reports.
Participating Entity #1
Participating Entity #3
Participating Entity #5
Participating Entity #10
Participating Entity #14

PCMH+ Participation Detail - April to August 2018
FQHC PCMH & PCMH+ Member Complaint Summary - August 2018
PCMH+ Member Complaint Summary - August 2018

July 2018

June 2018

PCMH+ Participation Detail - April to June 2018
FQHC PCMH & PCMH+ Member Complaint Summary - June 2018
PCMH+ Member Complaint Summary - June 2018

May 2018

PCMH+ Participation Detail April to May 2018
FQHC PCMH & PCMH+ Member Complaint Summary - May 2018
PCMH+ Member Complaint Summary - May 2018

In May, the Wave 2 PCMH+ Member Welcome Letters were sent to HUSKY members who's medical home is participating in Wave 2. Letters were divided into three groups. Below are the groupings and copies of the letter available for download (PDF) in both English and Spanish. Also posted below are materials shared during the May 15 PCMH+ Collaborative meeting.

May 15 Collaborative Meeting Material

PCMH+ Provider Collaborative Presentation Wave 2
211 Brochure
CT Child Development Infoline
Enhanced Care Coordination Activities
Enhanced Care Coordination Guide
HUSKY Covered Services Quick Guide
PCMH+ One-Sheet (English)
PCMH+ One-Sheet (Spanish)
PCMH+ PE Resource Packet
Underservice Utilization Strategy

PCMH+ Status Update May 2018 SIM Steering Committee

PCMH+ Member Video

Wave 2 Welcome Letter Mailings

Group 1 - Wave 1 Participating Entities who will Participate in Wave 2
Wave 1 Members (English)
Wave 1 Members (Spanish)

Group 2 - New Participating Entities
New Members (English)
New Members (Spanish)

Group 3 - Members who Opted Out of Wave 1 have the option to join Wave 2 or remain Opted Out
Members who opted out during Wave 1 (English)
Members who opted out during Wave 1 (Spanish)

April 2018

PCMH+ Participation Detail April 2018
PCMH+ Complaint Report Summary (from April 18 Webinar presentation)
FQHC PCMH & PCMH+ Member Complaint Summary - April 2018
PCMH+ Member Complaint Summary - April 2018

March 2018

REVISED 2017 Mystery Shopper Report
An error was found on the 2017 Mystery Shopper report which affected the bucketing of results of 5 calls. The report has since been corrected. Please find the revised version with changes highlighted.

2017 Mystery Shopper Survey Final Report (original report)
Fair Haven Community Health Care Response to 2017 Mystery Shopper Survey Final Report
Value Care Alliance Response to 2017 Mystery Shopper Survey Final Report

PCMH+ Participation Detail January 2017 to March 2018
FQHC PCMH & PCMH+ Member Complaint Summary - March 2018

February 2018

PCMH+ Participation Detail – January 2017 to February 2018
FQHC PCMH & PCMH+ Member Complaint Summary - February 2018

Participating Entity Monthly Reports – February 2018
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9

January 2018

PCMH+ Participation Detail January 2017 to January 2018
FQHC PCMH & PCMH+ Member Complaint Summary - January 2018

Participating Entity Monthly Reports – January 2018
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9

2017

December 2017

FQHC PCMH & PCMH+ Member Complaint Summary - January to December 2017

Participating Entity Monthly Reports – December
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9

November 2017

October 2017

PCMH+ Participation Detail – January to October 2017

Participating Entity Tools and Resources (provided at Collaborative Meeting)
Connecticut Association for Community Action (CAFCA) Presentation
Comparison Group Presentation
Shared Savings Example

Participating Entity Monthly Reports - October
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4 (pending)
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9

September 2017

PCMH+ Participation Detail – January to September 2017
FQHC PCMH & PCMH+ Member Complaint Summary - January to September 2017

Participating Entity Monthly Reports – September
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9

August 2017

PCMH+ Participation Detail – January to August 2017
FQHC PCMH & PCMH+ Member Complaint Summary - January to August 2017

Participating Entity Monthly Reports – August
Participating Entity #1
Participating Entity #2
Participating Entity #3
Participating Entity #4
Participating Entity #5
Participating Entity #6
Participating Entity #7
Participating Entity #8
Participating Entity #9

Participating Entity Tools and Resources (provided at Collaborative Meeting)
CT Child Development Infoline
Online Resources for CYSHCN and TAY
PCMH+ Shared Savings Calculation Presentation
Connecticut NEMT Program Webpage
Connecticut NEMT Guide / Handbook
PCMH+ Phone Survey Opt Out Detail

July 2017

June 2017

Special Notice to PCMH+ Participating Entities
Connecticut's Person-Centered Medical Home-Plus Initiative
Update/June 29, 2017

PCMH+ is a State of Connecticut initiative administered by the Department of Social Services that was launched on January 1, 2017. PCMH+ represents an opportunity for Connecticut Medicaid to build on, but not supplant, its existing and successful Person-Centered Medical Home (PCMH) initiative, through which over 43% of members are being served. While PCMH will remain the foundation of care delivery transformation, PCMH+ is building on PCMH by incorporating additional requirements for care coordination, focusing upon integration of behavioral and physical health care, children with special health care needs, health equity, and competency in care for individuals with disabilities. It also represents the Department's first use of an upside-only "shared savings" approach under which participating providers that meet specified quality standards and generate savings for Medicaid will receive a portion of the savings that are achieved. DSS is very proud of all PCMH+ Participating Entities for committing to build on longstanding support for Medicaid members.

All of you are deeply committed to further transforming your practices, beyond being Person-Centered Medical Homes, to make them as receptive and coordinated as possible for the people whom you serve.
All of you are working hard to implement important and challenging new features of care coordination, including coordination of medical and behavioral health care, that will continue to improve members' care experience and outcomes.
All of you are working together in an active, dynamic, provider-led collaborative that is meeting regularly and diving into the actual day-to-day practice of how to support people with complex needs.
All of you are using extensive Medicaid data, provided by the Community Health Network, Inc. (CHN-CT) through the PCMH portal, to advance evidence-based practices and, most important, to identify and fill members' gaps in care.
All of you are coordinating with CHNCT on transition of people who previously received CHN-CT Intensive Care Management.
All of you are working, as is DSS, with helping Medicaid members to retain eligibility, to understand their covered benefits, and to help them coordinate the full range of their health needs.

DSS is proud of the process that the state has observed in developing PCMH+. We have participated in countless meetings and work groups and webinars on model design with the General Assembly's Medical Assistance Program Oversight Council Care Management Committee. DSS also reported extensively on PCMH+ to the State Innovation Model (SIM) Steering Committee. Collectively, we have carefully listened to, and incorporated many aspects of the feedback that we have received from advocates. The entire process is carefully documented on the MAPOC website.

Finally, we believe that this program deserves to have the opportunity to flourish. The public doesn't have to wonder how you are doing in your work. You are submitting detailed monthly reports to document the intense effort and learning in which you are involved. These reports are all being posted publicly on this dedicated web page. Further, DSS has signaled exactly how the program will be monitored, using a range of tools including claims

We agree that accountability is extremely important in this ambitious new program. But equally important is attention to facts and experience. We are confident that the record speaks directly to a strong positive launch of PCMH+, and a great deal of potential for good on behalf of Medicaid members. We are also proud of the open, public, collaborative process used to develop PCMH+ and that is being used to conduct the initiative. We will continue to encourage everyone involved to get to know, and monitor, our collective progress.

Thank you!
Kate McEvoy, Director, Division of Health Services
Dr. Rob Zavoski, Medical Director, Division of Health Services

May 2017

April 2017

January 2017

SPA 17-002 PCMH+ - Approval Package
Connecticut Regulations Concerning PCMH+

2016

December 2016

The Department hosted two informational sessions to discuss the provider's roles and responsibilities, Enhanced Care Coordination Activities, and PCMH+ Quality Measures.

Information Session Presentation
PCMH+ Enhanced Care Coordination Activities Guide

November 2016

The Department has been working with the Centers for Medicare and Medicaid Services (CMS) to obtain State Plan Amendment (SPA) approval for the PCMH+ program. A state plan is an agreement between the State and Federal government which gives assurances that the State will abide by Federal rules. The state plan allows for the claiming of Federal matching funds, outlines individuals and services to be covered, and how the State administers the Medicaid program. Currently, CMS is in the informal stages of the PCMH+ SPA approval process and discussions between DSS and CMS are ongoing.

Enhanced Care Coordination Activities
Quality Measure List
Quality Measure Descriptions
Measures of Under-Service

Member Welcome Letter (English)
Member Welcome Letter (Spanish)

Information Session (English)
Information Session (Spanish)

June 2016

The Department issued a Request for Proposal (RFP) from qualified Federally Qualified Health Centers and Advanced Network Lead Entities (on behalf of Advanced Networks) to become Participating Entities in the PCMH+ Program. Selected FQHCs and Advanced Networks will provide care coordination activities to improve the quality, efficiency, and effectiveness of care delivered to Medicaid beneficiaries. The RFP closed on August 2, 2016.

PCMH+ Request for Proposal