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.

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

Updates

Advanced Medical Homes Tier 3 “Glidepath” Payments Update

In February, NC Medicaid announced that effective April 1, 2021, NC Medicaid will offer time-limited payments to practices that have attested as an AMH Tier 3 provider as part of the transition to Medicaid Managed Care. The functionality to attest to an AMH Tier 3 provider is now live in NCTracks.

Providers must complete attestation by March 30, 2021 to be eligible for payments beginning in April. However, providers will have additional opportunities to complete attestation and receive payments for May and June.

For more information, visit Advanced Medical Home Tier 3 “Glidepath” Payments Update.
 

Advanced Medical Home Provider Manual 2.0 

The Department has released the Advance Medical Home (AMH) Provider Manual 2.0 that reflects all program modifications and changes that impact provider contracts. This manual replaces the previous version published on Dec. 12, 2019. 

Advanced Medical Home Tier 3 “Glidepath” Payments 

Effective April 1, 2021, NC Medicaid will offer a time-limited payment opportunity to Advanced Medical Home (AMH) Tier 3 practices. This payment opportunity is intended to provide an incentive for managed care launch readiness as well as provide funding to offset some of practices’ Tier 3 implementation costs. Payments will only be available for the months of April, May and June, 2021. Click here to view the Glidepath presentation under the "Resources" section below. For more information, please see the Advanced Medical Home Tier 3 “Glidepath” Payments bulletin article.  

Advanced Medical Home Webinar Series Begins December 10

A new Medicaid Managed Care webinar series on the AMH program will begin Dec. 10, 2020. The series will provide Medicaid primary care practice staff and clinicians with more information on North Carolina’s AMH model and how to function at the highest AMH Tier possible when Medicaid Managed Care goes live in July 2021. 

The series is designed to support practice managers, quality improvement professionals, care coordinators, and others within your practice who are responsible for meeting the NC Medicaid AMH Tier 2 or 3 requirements. This series will occur the second Thursday of each month beginning in December 2020 and continue through May 2021. Click here for more information and to register for the series. 

Previous training is available on the AMH Training Page

Resources

AMH Provider Manual 2.0 (Feb. 21, 2021)
Glidepath presentation (Feb. 1, 2021)
AMH Data Specification Guidance
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

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
Protocal for Changing Advanced Medical Home Tier Status

Frequently Asked Questions

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

    Additional Information