PCCM stands for which program model?

• A. Primary Council Case Method
• B. Primary Care Case Management
• C. Personal Care and Client Management
• D. Provider Case Management Model

Answer: (B)

PCCM stands for Primary Care Case Management, a Medicaid program model in which a designated primary care provider coordinates a beneficiary’s care. The PCP acts as the gatekeeper, deciding when specialty services are needed and arranging referrals, tests, and follow-up to ensure appropriate, coordinated care and to help control costs. Payment typically uses the fee-for-service system for medical services, with an added care-management component for the PCP (often a separate per-member-per-month payment) rather than paying a capitated amount to a managed care organization. This setup centers on the PCP’s role in managing the patient’s overall care rather than transferring all management responsibility to an HMO-like plan. The other terms listed aren’t standard names for Medicaid program models, so they don’t describe how PCCM operates.