Headline
Tool shares key features of approved state Medicaid health home programs.
Background
Since its introduction in 2011, the Medicaid health home model has been adopted by many states to improve care coordination and care management for beneficiaries with complex health needs. States prepare and submit state plan amendments to the Centers for Medicare & Medicaid Services (CMS) to include health homes as a covered benefit within their Medicaid program. This matrix lists 33 approved health home programs available to Medicaid members in 19 states.
About this Tool
The tool provides the following details on approved models:
-
The type of model, such as serious mental illness, chronic conditions, or substance use disorder;
-
Target population of the model such as people with serious mental illness, developmental and intellectual disabilities, or multiple chronic conditions;
-
Health home providers that are designated or enrolled to provide services, such as community mental health centers, clinical practices, and qualified care teams;
-
If eligible members can opt-in, opt-out, or self-refer to enroll;
-
How the program is financed, such as through fee-for-service, risk-based managed care, bundled or case rates, or an alternate payment methodology; and
-
Whether the program is available statewide or within specific counties in a state.
Policy/Program Takeaways
States can use this matrix to understand different Medicaid health home approaches implemented for members with complex health needs. This tool is part of CMS’ Health Home Information Resource Center, a resource library that helps states develop health home programs for their Medicaid population.