Person-Centered Healthcare Homes

One Stop Shopping: What does the Health Home Model mean for Behavioral Health? Check out our most recent edition of eSolutions to learn more about Article 2703 and how it will affect your state.

Frequently recommended in healthcare reform, the Patient-Centered Medical Home is a team-based clinical approach that includes the consumer, his or her providers, and family members, when appropriate. This approach centralizes care management and supports individuals as they work toward self-management goals.

Care management is central to the Medical Home’s recent shift away from focus on episodic acute care to focus on health management of defined populations, especially those living with chronic health conditions. This shift in focus has also led to national dialog that includes lessons learned from primary and behavioral health integration efforts. In fact, many now propose renaming this clinical approach “Person-Centered Healthcare Home,” recognizing the importance of caring for the whole person. Such a shift would necessitate integrating primary and behavioral healthcare and, as seen in the IMPACT model, explicitly building care manager/behavioral health consultant and consulting psychiatrist functions into the Medical Home model.

This emerging “Health Home” concept is an innovate approach to healthcare service delivery that promises better patient experience and better results than traditional care. While it has many characteristics of the Patient-Centered Medical Home, the Health Home can be customized to meet the specific needs of low-income patients with chronic medical conditions.

The Health Home is the next step in improving on the Patient-Centered Medical Home.

Resources from CIHS

The SAMHSA-HRSA Center for Integrated Health Solutions’ Behavioral Health Homes for People with Mental Health & Substance Use Conditions: The Core Clinical Features helps prepare behavioral health provider organizations to become health homes by outlining the essential clinical features. In addition, the paper introduces several real-world examples of how behavioral health provider organizations are successfully implementing the clinical features of a health homes around the country.

Federal and State Policy

New Health Home Information Resource Center Launched on Medicaid.gov

In the two years since the Affordable Care Act authorized the creation of Medicaid health homes (Section 2703), states have embraced these models to provide comprehensive care coordination for Medicaid beneficiaries with chronic conditions. During this time the Integrated Care Resource Center (ICRC) has offered technical assistance resources to states to support the development of health home programs. Now, ICRC's health home resources are moving to Medicaid.gov.

The new Health Home Information Resource Center on Medicaid.gov offers a variety of technical assistance services for states as well as a resource library of continuously updated materials. States may use the resource center to request one-on-one technical assistance, access peer-learning opportunities, and find resources to guide their health home design and implementation.

Health home technical assistance activities are provided by Mathematica Policy Research and the Center for Health Care Strategies with support from the Centers for Medicare & Medicaid Services. Technical assistance resources for integrating the care of Medicare-Medicaid enrollees ("dual eligibles") will remain part of ICRC.

States can request health home technical assistance, by completing the request form available at Medicaid.gov and sending it to healthhomes@cms.hhs.gov.

LEARN MORE>>

In the November issue of Health Affairs, NASHP Program Director, Mary Takach, authored the article, About Half Of The States Are Implementing Patient-Centered Medical Homes For Their Medicaid Populations, which focuses on trends in Medicaid patient-centered medical home payment that can inform public and private payment strategies more broadly. Both public and private payers are testing the patient-centered medical home model by shifting resources to enhance primary care as an important component of improving the quality and cost-effectiveness of the U.S. health care delivery system.

The Integrated Care Resource Center (ICRC) is a national initiative of the Centers for Medicare & Medicaid Services to help states improve the quality and cost-effectiveness of care for Medicaid’s high-need, high-cost beneficiaries. View their health homes fact sheet, and their state health home resources including a map of State Health Home activity. Also view the ICRC resources to help providers, patients, and caregivers better manage care transitions.

New York State has received approval on its health home State Plan Amendment, making it among one of the first in the nation. The state has posted its amendment, rate information, provider qualifications, a more. In addition, webinar slides.

The Affordable Care Act authorized a health home provision [Sec. 2703 & Sec. 19459(e)] that enables states to build a person-centered care system to improve outcomes for beneficiaries and ensure better services and value for state Medicaid and other programs, including mental health and substance abuse agencies. SAMHSA's Health Homes webpage houses a host of information, including state guidance on ACA Sec. 2703 (the health home provision) for people with behavioral health disorders.

Missouri was the first state to submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services, and it is the first state to receive approval. The Missouri Department of Mental Health makes many of their resources available online.”

Resources

The Collaborative Care: An Evidence-Based Approach to Integrating Physical and Mental Health In Medical Health Homes webinar highlighted details of the Collaborative Care Model, describes the evidence documenting its effectiveness, and describes how it operates from the perspective of primary care providers, specialty mental health providers, and payers. It also provides a brief update on health home activities at the national level with a focus on efforts to integrate physical and behavioral health services.

The Centers for Medicare & Medicaid Services (CMS) released new guidance related to health homes, authorized by section 2703 of the Affordable Care Act. This is a recommended core set of health care quality measures for assessing the health home service delivery model that CMS intends to promulgate in the rulemaking process. Click here to view the Health Home Core Quality Measures.

AHRQ’s Early Evidence on the Patient-Centered Medical Home, released in February 2012, looks at more than 480 practices, and provides a table summarizing findings on pages 9-10.

The National Council for Community Behavioral Health Care developed Behavioral Health/Primary Care Integration and The Person-Centered Healthcare Home, a report that assesses the need and importance of Health Homes, models, and policies that affect the implementation and sustainability of Health Homes. The Care Models for Persons with Chronic Substance Use video also discusses the National Council report.

The National Association of Community Health Centers Magazine published the article “The Evolution of the Primary Care Medical Home”, authored by NACHC’s David Stevens MD, FAAFM, to provide health centers with background and guidance on implementing Medical and Health Homes.

The Patient-Centered Primary Care Collaborative (PCPCC) aims to improve the American healthcare system by facilitating improvements in patient-physician relations and creating a more effective and efficient healthcare delivery model. To achieve these goals, the PCPCC has become a major developer and advocate of the patient-centered medical home model.

Introduction to the Patient-Centered Medical Home is a multimedia program developed to explain this model of healthcare to consumers. The program is the result of collaboration between the PCPCC and Emmi Solutions.

NCQA’s Patient-Centered Medical Home 2011 is an innovative program for improving primary care. In a set of standards that describe clear and specific criteria, the program gives practices information about organizing care around patients, working in teams, and coordinating and tracking care over time. The NCQA Patient-Centered Medical Home standards strengthen and add to the issues addressed by NCQA’s original program.

The Joint Principles of the Patient-Centered Medical Home were developed by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association to describe the characteristics of the Patient-Centered Medical Home.

Webinars

A (Health) Home Run: Operationalizing Behavioral Health Homes
January 18, 2013
Presented by Laurie Alexander, Benjamin Druss, and Joe Parks

Integrated Care within the Patient Centered Medical Home: The Health Center Perspective
November 8, 2012
Presented by Ann Lewis, Judith Steinberg, and Marty Lynch

Behavioral Health Homes: The Core Clinical Features
May 30, 2012
Presented by Laurie Alexander and Benjamin Druss

• Recording

• Presentation

• Transcript

Person-Centered Health Homes Webinar
May 16, 2011
Presented by Chuck Ingoglia and Larry Fricks