States that are interested in establishing Medicaid health homes programs need to be prepared to submit a state plan amendment (SPA) and prepare themselves for the in-depth process that is involved. Peter provided a review of the OTP Health Home Revenue and Cost Analysis as it pertained to the development of the State Plan Amendment (SPA) and ongoing financial components of this initiative. Requirements vary from state-to-state but for the purposes of his presentation, Peter focused on Rhode Island, the state where SMART and Discovery House are headquartered.
Also covered were the sustainability of the initiative, State budget factors and an analysis of claims data surrounding the three major focuses from a cost perspective: hospital admissions /re-admissions, emergency room visits and skilled nursing facility admissions. The desired outcome of this initiative is an improved focus on the healthcare of individuals, thereby creating a reduction in healthcare costs.
For more information on design and implementation of Health Home Programs visit Medicaid.gov
About Health Homes
“A health home is a Medicaid State Plan Option that provides a comprehensive system of care coordination for Medicaid individuals with chronic conditions. Health home providers will integrate and coordinate all primary, acute, behavioral health and long term services and supports to treat the “whole-person” across the lifespan.”