Healthy Connections is a primary care case management program utilizing a network of primary care physicians and health care providers to coordinate care for Medicaid members.
Healthy Connections Value Care is a value-based care program, that includes hospital networks and primary care providers, who are held accountable for outcomes and costs, in exchange for an ability to share in savings.
The Healthy Connections (HC) program is sunsetting. By January 1, 2026, the department will discontinue contracting and reimbursing through value care organizations and the primary care case management program. What does this mean?
- Healthy Connections providers will receive notice that their Coordinated Care Agreement is being terminated. This does not impact their Medicaid Provider Agreement.
- The Healthy Connections primary care case management (per member per month) payment will cease December 31, 2025.
Though the Healthy Connections programs are ending, the importance of primary and preventive care is the same. Idaho Medicaid appreciates your support in coordinating member care and your continued dedicated service to the healthcare of Idahoans.
What we know now:
- References to Healthy Connections will be removed from the Idaho Administrative Code (IDAPA) after June 30, 2025. The Idaho Medicaid Provider Handbook will continue to have relevant content through the end of the program.
- Idaho Medicaid will stop enrolling new Healthy Connections providers.
- Idaho Medicaid has stopped auto-assigning members to HC providers. Members may request to enroll with an HC provider until October 31, 2025.
- Idaho Medicaid members may now see the primary care provider of their choice, without formal assignment. Referrals from a primary care provider are still encouraged.