Healthy Connections is the Idaho Medicaid program that helps participants connect with a Primary Care Provider (PCP)/clinic who will coordinate their healthcare needs.
- Your PCP will coordinate your care, including giving referrals to other providers to allow medically necessary services to occur.
- Healthy connections follows a fixed enrollment process
- You will stay enrolled with your PCP unless you qualify for a reason to change.
- You can change your PCP for any reason during Open Enrollment every July and August.
If you need additional information you can contact Healthy Connections at 888-528-5861 or by email at firstname.lastname@example.org.
Enrollment in Healthy Connections will be with a clinic, not a specific provider. The clinic will work with you to determine your specific primary care provider or primary care team.
When searching for a Healthy Connections Primary Care Provider, the results will show a Healthy Connections Tier 1, 2 or 3 next to the clinic. The provider requirements for those tiers are listed below:
Healthy Connections Tier I:
- Provide primary care including monitoring and coordinating patient care
- Provide timely referrals to medically necessary services
- Provide 24 hour, 7 days a week availability of information, referral, and treatment for emergency medical conditions
Healthy Connections Care Management Tier II:
- Provide all requirements listed in Healthy Connections Tier I
- Provide additional access to care, which may include:
- Being open 46 hours or more each week
- Having a patient portal
- Offering telehealth
- Provide patient outreach and education activities
- Provide quality improvement activities
- Provide care coordination
- Track and follow-up on referrals
- Exchange patient-level information with other healthcare systems
Healthy Connections Medical Home Tier III:
- Provide all requirements listed in Healthy Connections Care Management Tier 2
- Be nationally recognized as a Patient-Centered Medical Home
Medicaid participants enroll in the Healthy Connections Primary Care Program to achieve the best health outcomes.