Evaluation of the Medicaid Health Home Option for Beneficiaries with Chronic Conditions: Progress and Lessons from the First States Implementing Health Home Programs, Annual Report - Year Four

04/01/2016

This report presents findings from the first four years of the five-year evaluation of Medicaid health homes, a new integrated care model authorized in Social Security Act Section 1945 and created by Section 2703 of the Affordable Care Act. The model is designed to target high-need, high-cost beneficiaries with chronic conditions or serious mental illness. The Urban Institute is conducting the evaluation, which will conclude in early 2017. The first four years of the evaluation focus on the structure of health homes and implementation issues. Quantitative analysis in the last year of the evaluation will assess the impact on quality, cost, utilization patterns, and health outcomes. This evaluation will assess:

  • The care models and processes states are using.
  • The extent to which health homes result in increased monitoring and care coordination.
  • Whether these models result in better care quality; patient experience; reduced hospital, skilled nursing facility, and emergency department use; lower costs; and clinical outcomes.

     

The study evaluates 13 Medicaid Health Home programs created by State Plan Amendments (SPAs) approved in 11 states; these include two SPAs each for Rhode Island and Missouri, and one SPA each for North Carolina, Oregon, New York, Alabama, Iowa, Ohio, Wisconsin, Idaho, and Maine. This report summarizes program progress and presents the key lessons learned to date.

Findings from the evaluation will inform a 2017 Report to Congress.

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