PCMH Financial Incentives

The Department of Social Services (DSS) offers financial incentives to primary care practices that qualify for PCMH status to help offset the costs of becoming, maintaining, and operating as a PCMH for HUSKY Health program recipients.

Types of Financial Incentives

  1. Enhanced Reimbursement Rates:* DSS PCMH providers will receive enhanced reimbursement rates on primary care services supplemental to the current Medicaid fee schedule. View a list of the PCMH Codes for Enhanced Reimbursement.
  2. Per Member Per Month (PMPM) Performance-Based Payments:* DSS offers PMPM performance-based payments on the aggregate performance of fully qualified PCMH practices. Payments are based on select adult and pediatric health measures of HUSKY Health members attributed to the practice during the performance period. A practice’s attribution for performance-based payments may differ somewhat from the attribution established in the monthly roster due to the exclusion of members dually eligible for Medicare and Medicaid and those with commercial insurance.

For a summary of the financial incentives that PCMH and Glide Path practices can qualify for, view the PCMH Financial Incentives Summary.

Maintaining Your Provider Roster

It is important that you maintain your provider roster by adding and removing practitioners in a timely manner using the PCMH and Glide Path Change Request Form. This is crucial when attributing members to your practice. An incorrect provider roster will affect your enhanced reimbursement rates and performance-based payments.

HUSKY Health Members Attributed to Your Practice

To help you track the members attributed to your practice, you have access to a monthly Patient Panel Report. The report includes a list of your attributed members and the names of their primary care practitioners. This report is one of many provider portal reports available to help you with the management of HUSKY Health members attributed to your practice. These are tools that could help you improve your performance-based payments.

You can find all portal reports and an explanation of the attribution process on the HUSKY Health secure provider portal. Primary care practices must sign up for secure portal access to view these reports.

Visit the Secure Provider Portal

*Glide Path practices do not qualify for the performance-based payments, but will receive a portion of the PCMH enhanced reimbursement rate.

We Can Help

You don’t have to go through the transformation process alone.

The process of PCMH transformation towards PCMH recognition has many components and practices may find the project challenging at times. Appropriate guidance can be invaluable. That’s why we offer support and assistance from a team of PCMH experts. The support from this team is priceless and is available at no cost to your practice.

Contact us today with any questions and we will be in touch.

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You can also give us a call at 203.949.4194

This portion of the HUSKY Health website is managed by Community Health Network of Connecticut, Inc., the State of Connecticut’s Medical Administrative Services Organization for the HUSKY Health Program. For the general HUSKY website gateway, please visit portal.ct.gov/husky. HUSKY Health includes Medicaid and the Children’s Health Insurance Program, and is administered by the Connecticut Department of Social Services.