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.
Advanced Medical Home Tier 3 Glidepath Payment Attestation Reconsideration Process
On April 21, 2021, the department released an overview of the AMH Glidepath Payment reconsideration process. Full details of the reconsideration process are now available which includes criteria for reconsideration and request submission details. For more information, please see the Glidepath Payment Reconsideration Process bulletin. The deadline for submission of Reconsideration Requests is May 23, 2021.
The deadline to attest for the June payment is May 14, 2021. If providers have successfully attested in a previous cycle they do not need to attest again.
Advanced Medical Home Webinar Series
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.
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
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
- Medicaid transformation: https://medicaid.ncdhhs.gov/medicaid-transformation
- Email questions or comments to: email@example.com