This report presents findings from the evaluation of CMS’s first multi-payer patient-centered medical home (PCMH) demonstration, which ran in eight states from 2011-2014. Participating states designed their own practice entry requirements, demonstration payments models, and technical assistance for practices – making this demonstration essentially eight demonstrations in one. Medicare’s payments were capped at $10 PBPM, on average; Medicaid and private payers offered similar payments. In interviews, participating providers reported extensive transformations to how they practice, and credited the care managers they had hired as having a positive impact on their high-need patients. Ultimately, four states generated net savings for Medicare, and four generated net losses. Impacts on utilization and care quality were also mixed across states.
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