For the past three years, Medicare, Medicaid, and private payers in eight states have been paying certified medical home practices monthly care management fees and providing additional support (e.g., data feedback, learning collaboratives, practice coaching) through the Multi-payer Advanced Primary Care Demonstration. In its first year, the demonstration included 3,800 health care providers, 700 practices, and 400,000 Medicare beneficiaries, and produced net savings for the Medicare program that totaled $4.2 million. Interviewees reported that demonstration payments provided needed support to help practices transform the way they deliver care – by adding nurse care managers, adopting electronic disease registries, and enhancing access to care after hours, as well as making other changes.

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