Patient Centered Medical Home (PCMH)


Answer Health promotes the Patient-Centered Medical Home (PCMH) care delivery model in all participating primary care practices and the PCMH-Neighbor (PCMH-N) model in participating specialist practices.

  • Strengthens the role of the PCP in the delivery and coordination of care.
  • Supports population health management, which uses a variety of individual, organizational and cultural interventions to help improve the illness and injury burden and the health use of defined populations.
  • Ensures effective communication, coordination and integration among all PCP and specialist practices, including appropriate flow of patient care information, and clear definitions of roles and responsibilities.

PCMH capabilities are implemented across our network to ensure patients receive the necessary care when and where they need it, and in the manner they can understand.

Quality Performance Programs

  • HEDIS measures
  • Physician Group Incentive Program (PGIP)
  • PCP Incentive Programs (PIP)
  • Physician Recognition Program (PRP)
  • PCP Value Based Reimbursements (VBRs)
  • Care management
  • Emergency department utilization
  • Resource Stewardship Initiative (RSI)

Utilization and Cost Performance

  • CAVE reports
  • Electronic Prescribing Controlled Substances (EPCS)

Integrated Care Teams

  • Medical Directors & Clinical Director
  • Quality Improvement Specialists
  • Care management (embedded & centralized)

Population Health Management

  • 95% designated PCMH practices

Value Based Reimbursement (VBR)

  • Education with practice specific dashboards