A new model of care called “health homes” is quietly spreading through many states, as Medicaid programs work to improve care for people with chronic conditions. The problem: Few people know what health homes are — or worse, they confuse them with home health services.
What are health homes? Health homes are not a place (even though “home” is in the term). They represent an approach in which providers or health teams coordinate care across settings for people with chronic physical or mental health conditions.
Health homes provide care management; care coordination; health promotion; transitional care from hospitals to other settings; individual and family support; and referrals to community and social support services. Health homes are expanding because of the Affordable Care Act, which created an optional Medicaid State Plan Amendment (SPA) benefit for states to establish them. States get money, too. They receive a 90 percent enhanced Medicaid match for the first two years.
What is my state doing? According to a recent AARP Public Policy Institute study, more than 30 states are either participating or are working to implement health homes. The figure illustrates state efforts as of May 2013.
Who are they? States can choose who can be health home providers. For example, they can pick:
- One provider such as a doctor, an advanced practice nurse, a clinic, a home health agency or another type of provider; or
- A team of health professionals that can include nurses, social workers and mental health professionals.
States can also target health home services to certain geographical areas, and they can target certain health conditions. Health homes can serve Medicaid recipients who:
- Have two or more chronic conditions;
- Have one chronic condition and are at risk for a second; or
- Have one serious and persistent mental health condition.
Why are they important? The key to this new model is care coordination. It is important because many people with chronic conditions see a variety of providers who often do not communicate with each other. This approach could be a viable solution for integrating and improving care across primary, acute, behavioral health, and long-term services and supports.
About the author: Wendy Fox-Grage is a senior strategic policy adviser for the AARP Public Policy Institute, where she works on long-term services and supports in the states. She has a Master of Science in gerontology and a master’s in public administration.