Advanced Medical Home

The North Carolina Department of Health and Human Services (DHHS) developed the Advanced Medical Home (AMH) program as the primary vehicle for delivering care management as the state transitions to Medicaid managed care. The AMH program builds on the Carolina ACCESS program.

The AMH program requires prepaid health plans (PHPs) to delegate certain care management functions to AMHs at the local level. In order to provide these care management functions, AMHs may work with their affiliated health care system or make an arrangement, with an entity called a Clinically Integrated Network, a Care Management vendor or other population health entity. To ensure that beneficiaries across the state are receiving high quality care management, DHHS developed standards for AMHs and will be responsible for initially certifying that practices meet AMH criteria.

Advanced Medical Home Technical Advisory Group

As part of ongoing Medicaid Transformation in North Carolina, DHHS has convened a Technical Advisory Group (TAG) to support the AMH program. The role of the AMH TAG will be to advise and inform DHHS on key aspects of the design and evolution of the AMH program. For more information on the AMH TAG, please click here

New Updates

Status Update: The Advanced Medical Home Program - April 18, 2019

As of March 25, 2019, nearly 2,800 individual practices across the state are certified to participate as AMHs, and nearly 1,500 have certified to participate in AMH Tier 3 since the certification process began in October, 2018. These practices range from large health systems to small independent practices. The graphic below gives the footprint of the AMH program across the state (click on the image to see a larger version).

NC Medicaid Managed Care regions, rollout dates and AMH tier statistics as of April 1, 2019

 

 

 

 

 

 

Practices interested in participating as an AMH can review or update their AMH tier status by logging into NCTracks (accessing AMH information through NCTracks). By completing an attestation through NCTracks, practices can choose to be a Tier 2 or 3 AMH, and once certified, begin contracting with PHPs.

Previous updates

Training

No training is currently scheduled, please check back regularly for updates. Previous training is available on the AMH Training Page

Resources

AMH Data Specification Guidance
AMH Provider Manual
Supporting Provider Transition to Medicaid Managed Care

Policy Papers

Clinically Integrated Networks and Other Partners Support of Advanced Medical Homes Care Management Data Needs
Data Strategy to Support the Advanced Medical Home Program in North Carolina
North Carolina's Care Management Strategy under Managed Care

Programmatic Guidance

Programmatic Guidance on the Care Management Component of PHP Capitation Rates
NEW: Programmatic Guidance on Risk Stratification for Tier 3 AMH Practices
Programmatic Guidance on PHP Contracting Requirements for Tier 3 AMH Practices

Frequently Asked Questions

AMH Frequently Asked Questions
Data Strategy Frequently Asked Questions

    Additional Information