Performance Improvement 2013-2014. How are States Implementing the Medicaid Health Home Option for Beneficiaries with Chronic Conditions?


The Affordable Care Act authorized a new model of care, the Medicaid Health Home, for high-need, high-cost beneficiaries with chronic physical conditions or serious mental illness. HHS is conducting a five-year evaluation to assess the care models and processes states are using, the extent to which health homes result in increased monitoring and care coordination, and whether these models result in better care quality, reduced hospital, skilled nursing facility, and emergency department use, and lower costs.

Early evaluation activities have focused on developing background materials on program design, implementation context, and conducting site visits in the four states with approved State Plan Amendments (SPAs)--Missouri, Rhode Island, New York, and Oregon. Health homes in these states focus on beneficiaries with serious mental illness, substance abuse, and chronic physical conditions. New York and Oregon have chosen to combine all three populations in single broadly focused SPAs. Missouri and Rhode Island each have one SPA focused on people with mental/behavioral health issues and community mental health centers as health home service providers, and a second SPA targeting a different population. With one exception, all four states are relying on per member per month payment for health home services.

Report Title: Evaluation of the Medicaid Health Home Option for Beneficiaries with Chronic Conditions: Final Annual Report - Base Year

Agency Sponsor: OASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: David DeVoursney, 202-690-6443

Contract Performer: The Urban Institute

Record ID: 10222 (May 17, 2013)

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"PerformanceImprovement2014.pdf" (pdf, 671.65Kb)

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