[1] In the mid-1980s, states began enrolling beneficiaries in their PCCM programs in an attempt to increase access and reduce inappropriate emergency department and other high cost care.
In 1981, the 97th session of Congress enacted the Omnibus Budget Reconciliation Act (OBRA) which allowed state Medicaid programs to implement risk-based managed care programs as well as PCCM, pending HCFA (now known as CMS) waiver approval.
In their earliest forms, PCCM programs closely resembled traditional fee-for-service Medicaid than managed care.
As PCCM programs matured, state goals have expanded to improving quality of care provided.
These include payment innovations, increased care management resources, improved performance monitoring and reporting, increased resources for management of serious and complex medical conditions and a variety of "medical home" innovations including performance-based reimbursement, better use of information technology, increased contact with patients and efforts to provide additional resources for physician offices.