Order from the Commissioner:
Click the following links to read the Administrative Rules of Montana regarding Specific Quality Measures:
Click the following links to read the Administrative Rules of Montana regarding Standards for Payment:
PCMH Education Subcommittee
March 4th, 12:00 - 1:00pm
PCMH Payor Subcommittee
March 5th, 10:00 - 11:00 am
PCMH Stakeholder Council
March 18th, 1:00 - 3:00pm
All meetings are held at the CSI Office
840 Helena Ave.
Call-in information for all meetings: (712) 432-1212
Access Code: 236-818-235
Commissioner Lindeen has approved three national accrediting agencies for inclusion in the Montana PCMH Program. The National Committee for Quality Assurance (NCQA), The Accreditation Agency for Ambulatory Health Care (AAAHC), and The Joint Commission met all the necessary criteria to become a recognized accrediting organization for Montana's PCMH program.
View lists of medical practices Commissioner Lindeen has qualified and provisionally qualified for the Montana PCMH Program here:
Approved payors for the Montana PCMH Program are listed below. Click on the name of each payor to read their letter of intent they submitted for PCMH reimbursement in 2015.
A Health Care Community
What if medical providers were paid to keep people healthy? We believe that simple concept could transform health care in Montana. That's the idea behind Patient Centered Medical Homes (PCMH).
A patient-centered medical home (PCMH) is not so much a place, as a community of health care professionals, lead by your primary care provider, focused on helping you become as healthy as you can be. Currently, providers are generally paid to treat illness and injury, providing incentives for excessive treatment, tests, and medication, leading to greater cost throughout the system. A PCMH allows for better acess to health care, increased satisfaction with care, and improved health outcomes for patients and communities. A PCMH team collectively takes responsibility for ongoing patient care at all stages, focusing on coordinating care and prevention.
The PCMH Act was created by Senate Bill 84, which was passed by the 2013 Montana Legislature. The law requires the insurance commissioner to rely on a council of stakeholders in creating standards for the program, qualifying health care providers and insurers to participate, and promoting the program. The volunteer council consists of representatives of primary care providers, health plans, Medicaid, public health, and consumer advocates.
For questions about the Montana Patient-Centered Medical Home Program contact Amanda Roccabruna Eby at firstname.lastname@example.org
The PCMH Stakeholder Council
Council members will consult Insurance Commissioner Lindeen in qualifying patient-centered medical homes. Stakeholders will work with CSI staff to determine which nationally recognized accrediting organizations will be included in our program, develop Montana specific standards and a qualification process for applicants. The council will also advise in promotion, education and coordination of the PCMH program by providing guidance concerning medical home activities. Meetings are typically the third Wednesday of every month at 1:00pm, at the CSI office unless announced otherwise.
The list of council members serving the 2014-2015 term is below.
Dr. Jonathan Griffin, St. Peter's Hospital
Paula Block, Montana Primary Care Association
Dr. Larry Severa, Billings Clinic
Dr. Janice Gomersall, Community Physicians Group, Mountain View Family Medicine and Obstetrics
Dr. Rob Stenger, Grant Creek Family Medicine, Providence Medical Group
Dr. Patrick Van Wyk, St. Peter's Medical Group
Tara Callaghan, Southwest Montana Community Health Center
Kristen Pete, Glacier Medical Associates
Carla Cobb, RiverStone Health
Todd Lovshin, PacificSource Health Plans
Dr. Monica E Berner, Blue Cross Blue Shield Montana
Jo Thompson, Medicaid
Todd Harwell, Public Health and Safety Division, Department of Public Health & Human Services
Bill Warden, St. Peter's, Bozeman Deaconess, and Benefis hospitals
Lara Shadwick, Mountain Pacific Quality Health Foundation
Sen. Mary Caferro, State of Montana (Ad Hoc Member)
Richard Opper, Director of the Montana Departement of Public Health and Human Services (Ad Hoc Member)