This bulletin applies to NC Medicaid Managed Care.
Following stakeholder engagement and review of departmental priorities, NC Medicaid will not be implementing the Advanced Medical Home (AMH) Standardized Performance Incentive Program (SPIP) at this time. We appreciate the significant time and input that providers, Health plans, and community partners contributed throughout the development of this program.
Health plans will continue to offer performance incentives payment arrangements to AMH practices in accordance with existing NC Medicaid requirements. Providers will continue to have access to value-based payment opportunities through their contracted health plans.
AMHs are NC Medicaid’s cornerstone primary care program, serving more than two million Medicaid members across the state. NC Medicaid is committed to supporting innovative primary care payment models that reduce provider burden and improve health outcomes for Medicaid beneficiaries.
Health plans are currently required to offer performance incentive payment arrangements to AMH practices based on a defined set of AMH quality measures.
To address administrative and clinical challenges providers experience when managing multiple performance incentive arrangements across Medicaid plans, NC Medicaid proposed an AMH Standardized Performance Incentive program. This program would have required Standard Plans and Tailored Plans to offer the option of a common pay-for-performance model to AMHs.
NC Medicaid remains committed to advancing value-based payment and primary care quality improvement across the Medicaid program. Updates on future initiatives will be shared as they develop.