Implementing Health Homes in a Risk-Based Medicaid Managed Care Delivery System

Center for Health Care Strategies Issue Brief

The Affordable Care Act (ACA) gives Medicaid programs the option to create health homes to coordinate and better integrate primary, acute, behavioral health and long-term services and supports for beneficiaries with complex and chronic conditions. Deborah Bachrach, special counsel with Manatt, collaborated with Dianne Hasselman of the Center for Health Care Strategies, Inc., to co-author an issue brief outlining how states may effectively integrate the federal home health option into their existing Medicaid managed care infrastructures.

Growing evidence suggests that care management services—particularly when provided at the point of care—not only improve quality but reduce costly and avoidable hospital and skilled nursing facility admissions and emergency room visits. The demonstrated effectiveness of care management models coupled with the availability of enhanced (although time-limited) federal matching dollars makes the health home option particularly attractive to state Medicaid programs.

The brief addresses the opportunities for grounding health home programs in risk-based managed care organizations (MCOs) and the factors states should consider in deciding how best to proceed. It details some of the implicit advantages of MCO environments for the development of health homes, as well as some challenges that states may encounter.

Additional Author:
Dianne Hasselman (CHCS)



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