Under the Affordable Care Act (Section 2703), the Health Home State Plan Option allows states to design health homes to specifically provide comprehensive care coordination and disease management for Medicaid beneficiaries with chronic conditions. As of August 2015, 19 states have 26 approved Medicaid health home models in operation.
Who Is Eligible for a Health Home?
Health Homes are for people with Medicaid who:
- Have 2 or more chronic conditions
- Have one chronic condition and are at risk for a second
- Have one serious and persistent mental health condition
Chronic conditions listed in the statute include mental health, substance abuse, asthma, diabetes, heart disease and being overweight. Additional chronic conditions, such as HIV/AIDS, may be considered by CMS for approval.
- States can target health home services geographically
- States can not exclude people with both Medicaid and Medicare from health home services
What are health home services in Section 2703?
The health home services include:
- Comprehensive care management;
- Care coordination;
- Health promotion;
- Comprehensive transitional care/follow-up;
- Patient and family support; and
- Referral to community and social support services.
More Health Homes FAQ
Health Home Resources:
- Approved Health Home State Plan Amendments
- Interim Report to Congress on the Medicaid Health Home State Plan Option [PDF]
- Medicaid Health Homes: Implementation Update [PDF]
- Seizing the Opportunity: Early Medicaid Health Home Lessons [PDF]
- Seizing Opportunities Under The Affordable Care Act For Transforming The Mental And Behavioral Health System (Health Affairs)
- The Collaborative Care Model: An Approach for Integrating Physical and Mental Health Care in Medicaid Health Homes [PDF]