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 ofindividuals eligible under the State plan or “under a waiver ofsuch 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 conditionSubstance use disorderAsthmaDiabetesHeart diseaseBeing overweight, as evidenced by a body mass index over 25Section 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 TC 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 NC 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 PI 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 SR 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 TT 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 servicesUtilizing a person-centered approach while ensuring personal choice in service planning and delivery optionsAligning efforts with other payment improvement initiativesDeveloping performance measures to ensure improved care coordination, patient engagement, and health outcomes

NEXT STEPS