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HEALTH HOMESA R K A N S A S D E P A R T M E N T O F H U M A N S E R V I C E S
LO N G -T E R M C A R E P O L I C Y S U M M I T
S E P T E M B E R 5 , 2 0 1 2
HEALTH HOMES OPTION
Health Homes for Enrollees with Chronic Conditions Option is authorized by Section 2703 of the Affordable Care Act
The option became effective on January 1, 2011
A state may elect this option through an amendment to the Medicaid State Plan
Section 2703 of the Affordable Care Act
COMMON HEALTH HOME QUESTIONS
What is i t?
Where is i t located?
What purpose wi l l i t serve?
PURPOSE OF HEALTH HOMES OPTION
S t a t e p l a n o p t i o n t o p ro v i d e enhanced in tegra t ion and coord inat ion o f p r i m a r y , a c u t e , b e h a v i o r a l h e a l t h ( m e n t a l h e a l t h a n d s u b s t a n c e u s e ) , a n d l o n g -t e rm s e r v i c e s a n d s u p p o r t s f o r p e r s o n s a c ro s s t h e l i f e s p a n w i t h c h ro n i c i l l n e s s
POPULATION CRITERIA
The health home population the State elects must consist of
individuals eligible under the State plan or “under a waiver of
such plan” who:
H AV E AT L E A S T T W O C H R O N I C C O N D I T I O N S
H AV E O N E C H R O N I C C O N D I T I O N A N D B E AT R I S K F O R A N O T H E R
H AV E O N E S E R I O U S A N D P E R S I S T E N T M E N TA L H E A LT H C O N D I T I O N
CHRONIC CONDITIONS:THE CHRONIC CONDITIONS DESCRIBED IN SECTION 1945(H)(2) OF THE ACT INCLUDE:
Mental health condition
Substance use disorder
Asthma
Diabetes
Heart disease
Being overweight, as evidenced by a body mass index over 25
Section 1945(h)(2) of the Act authorizes the Secretary of DHHS to expand the list of chronic conditions reflected in this provision. Additional chronic conditions, such as HIV/AIDS, will be considered for incorporation into health home models.
CURRENT CARE COORDINATION ROAD MAP
OR…
HEALTH HOME SERVICESSection 1945(h)(4) of the Act defines health home
services as
comprehensive and timely high quality services”
C O M P R E H E N S I V E C A R E M A N A G E M E N T
C A R E C O O R D I N A T I O N A N D H E A LT H P R O M O T I O N
C O M P R E H E N S I V E T R A N S I T I O N A L C A R E F R O M I N P A T I E N T T O O T H E R S E T T I N G S , I N C L U D I N G A P P R O P R I A T E F O L L O W - U P
I N D I V I D U A L A N D FA M I LY S U P P O R T, W H I C H I N C L U D E S A U T H O R I Z E D R E P R E S E N T A T I V E S
R E F E R R A L T O C O M M U N I T Y A N D S O C I A L S U P P O R T S E R V I C E S , I F R E L E V A N T
T H E U S E O F H E A LT H I N F O R M A T I O N T E C H N O L O G Y T O L I N K S E R V I C E S , A S F E A S I B L E A N D A P P R O P R I A T E
HEALTH HOME PROVIDERS:
Designated providersA team of health care professionals, which links to a designated providerA health team
States can choose providers arrangements from one or more of the following options:
PROVIDER STANDARDS:STATES WILL BE EXPECTED TO DEVELOP HEALTH HOME MODEL S WITH COMPONENTS THAT FOCUS ON:
Service delivery
Provider qualifications
Ongoing standards compliance
KEY CONSIDERATIONS FORARKANSAS’ HEALTH HOME MODEL
Defining target populations to benefit from health home services
Utilizing a person-centered approach while ensuring personal choice in service planning and delivery options
Aligning efforts with other payment improvement initiatives
Developing performance measures to ensure improved care coordination, patient engagement, and health outcomes
NEXT STEPS