Impact of New York State’s Health Home Model on Health Care Utilization

Scott Wetzler, Nathaniel Counts, Bruce Schwartz, Urvashi Patel, Samantha Holcombe
Peer-Reviewed Article
March 2023


Health homes significantly decreased rates of inpatient utilization over two years for adults receiving mental health treatment.


The Affordable Care Act established a Medicaid health home option for states that is designed to serve people with multiple chronic conditions or serious mental illness through care management/care coordination interventions. There are few studies on the effectiveness of the health home model in reaching its intended goal of reducing unnecessary hospitalizations or its impact on health outcomes. This study evaluates the impact of the New York State health home program on enrollees receiving mental health treatment through a pre-post analysis of inpatient utilization.


The authors examined claims data on more than 10,000 adult health home enrollees who had at least one mental health visit during the year prior to their health home enrollment and also extracted claims data for the period two years after their health home enrollment. In the sample, 51% had a serious mental illness and 33% had substance use disorders. Overall, over two years, there were significant decreases in rates of inpatient utilization for mental health (43% decrease) and substance use (38% decrease) and a smaller decrease in rates for medical hospitalizations (7%). Alongside these findings, there were increases in behavioral health medication utilization and mental health outpatient visits.


This study provides evidence to suggest that health home enrollment for people receiving mental health treatment may effectively prevent unnecessary hospitalizations and facilitate engagement in outpatient behavioral health care. Given the dramatic decrease in behavioral health-related hospitalizations in this study, this preliminary evidence can support policymakers seeking to reduce the costs associated with treating people with behavioral health conditions.

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