New payment model at Cook County Medicaid plan


The arrangement aims to provide consistent revenue to some clinics in vulnerable communities at a time when many patients are avoiding in-person care.

As fewer patients seek medical care amid the COVID-19 pandemic, Cook County Health’s Medicaid plan is instituting a new payment model to support some clinics in vulnerable communities.

CountyCare and the Medical Home Network Accountable Care Organization have entered into a new reimbursement agreement with some government-funded community health centers. Under the deal, doctors will get a set amount per patient per month, rather than getting paid for each medical service provided.

The new payment model applies to the 120,000 patients—about 37 percent of CountyCare’s Medicaid members—whose care is coordinated by Medical Home Network Accountable Care Organization, or MHN ACO. All but one of the federally qualified health centers in MHN ACOs’ network opted to abandon the traditional fee-for-service arrangement, CEO Cheryl Lulias said. She said the model—which does not extend to hospitals—will support goals around population health.

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