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 NC 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.

AMH 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. 

Resources

AMH Provider Manual
AMH Tier 3 Glidepath Payment Reconsideration Process and Attestation Program Update (Dec. 17, 2021)
Glidepath presentation (Feb. 1, 2021)
AMH Data Specification Guidance
AMH Training Page
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

Glidepath Payment Reconsideration Process bulletin (May 7, 2021)
Notice of AMH Policy Changes Requiring Modifications to AMH Provider Contract Templates memo (Nov. 16, 2020)
Provider Contract Templates memo
Programmatic Guidance on Care Management Component of PHP Capitation Rates
Programmatic Guidance on Risk Stratification for Tier 3 AMH Practices
Protocol for Changing Advanced Medical Home Tier Status

Frequently Asked Questions

AMH Frequently Asked Questions (Dec. 11, 2019)
Data Strategy Frequently Asked Questions

Additional Information

• Medicaid Transformation: https://medicaid.ncdhhs.gov/medicaid-transformation
• Email questions or comments to: medicaid.transformation@dhhs.nc.gov