The Blueprint

The Blueprint blog is the main channel that we use to let Medical Home Project participants know about upcoming events, new tools, and research.

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We invite you to send us links, information, dilemmas or lessons learned that you think your peers in the project might like to see on this blog. Email me at with anything you would like to see included.

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Amanda Berra

How did CCNC save nearly $1B?

Amanda Berra January 10, 2012

One of the trickiest pieces in the puzzle of medical home financial sustainability is fully understanding PCMH ROI. Case in point: recent reports claim that Community Care of North Carolina (CCNC) avoided $984 million in Medicaid health spending over four years by placing 1.1 million Medicaid enrollees in medical homes. This headline begs two questions:

  • How did they do that?
    The success is chalked up to the medical home model, but savvy providers—who know how diverse models called “medical home” can be—know that more information is needed to explain exactly what this particular medical home is or what it does.
  • Did CCNC really save $984M?
    Again, experienced medical home observers know that in the world of medical home, “savings” are often very challenging to quantify. Savings figures are always modeled out compared to a control group or what would have been spent—they are almost never an absolute decline in spending compared to the past. So it's always important to look at where the numbers are coming from.

Here, a quick look into Community Care of North Carolina’s particular version of the medical home, the operational changes that resulted substantial savings, and the context of how estimates of CCNC’s savings have changed over the years.

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Asking the right questions: Discussion guide for payer talks

Amanda Berra January 4, 2012

Providers are increasingly approaching health plans and employers to initiate discussions of medical home contracting opportunities. We all know how critical it is to come to the negotiating table thoroughly prepared with good discussion questions. But when it comes to medical home contracting, what are those good questions?

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What is a Medicaid Health Home

Amanda Berra December 12, 2011

Through their states, providers are currently eligible for increased federal reimbursement for the provision of Health Home services to the Medicaid population. The Health Home model includes a team-based approach to providing comprehensive, person-centered care and integrating the physical and mental health needs of patients -- basically, a very robust version of the medical home (PCMH) model.  

In this blog entry, my colleagues Megan Clark and Yulan Egan detail the "what" of the model, as well as how providers can reach out to states to become involved and qualify for federal funding.

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Training health coaches: Inside Mercy Clinics' program

Amanda Berra August 8, 2011

Health coaching is, without question, a cornerstone of the medical home model. According to our data, about 50% of practices transitioning to the medical home model add new health coach staff, while other sites work with the existing team to expand emphasis on health coaching activities. Either way, ensuring right skill set is a major challenge: Many organizations have had difficulty filling the role with staff with all the clinical, organizational, and "people' skills required to deliver real results.

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Launching 45 medical homes in one year

Amanda Berra August 1, 2011

The most recent Medical Home Project Innovator Spotlight Series webconference showcased the work of Baylor Healthcare in building a system-level platform to support a major multi-site rollout of the PCMH model. Administrators walked through their approach, challenges, and lessons learned.

Slides and recorded audio for the webconference are both located here

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Medical Home Project now on Twitter

Amanda Berra August 1, 2011

In addition to this blog, we also starting to share more frequent updates on Twitter. It turns out to be a great way to share breaking medical home developments and some of the interesting items and links that crop up every day in the research of the Medical Home Project.

  • If you use Twitter, please follow us at 
  • If you've never used Twitter, this is a perfect, professionally defensible opportunity to try it out!

Benchmarking clinical support staff in primary care sites

Amanda Berra July 26, 2011

We receive many requests for primary care clinical support staff benchmarks specific to certain types of PCMH (or general primary care) sites, for example, integrated delivery systems, independent practices, large practices, small practices, high-capitation markets, etc.

Here, a current set of benchmarks for all medical home site types, along with answers to questions about benchmarking by site type.

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How can an employer access PCMH services?

Amanda Berra June 13, 2011

We recently received an inbound inquiry from a Fortune 100 employer: "We have heard about this new care model called 'medical home' that could help us save money on healthcare costs, and is supposed to be better for patients. How can we get involved?"

Unfortunately, our research indicates that, at least for now, there is no simple answer to that request. Despite a rapid increase in medical home development nationwide, there is no often clear way for most corporations--even hospitals as employers-- to enroll their employees in a medical home today

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