Medicaid Health Homes a “Promising” Addition for Managed Senior Care

Low income seniors may have new opportunities in receiving home health care in at least six states, as Medicaid recently announced the states’ adoption of a new program that focuses on funding “health homes” for beneficiaries with chronic conditions, according to a paper published by the Kaiser Commission. 

Seniors on low income budgets are part of a group that makes up 15% of Medicaid beneficiaries, but accounts for nearly 40% of Medicaid spending. The new state-enforced “health homes” program was created to combat further cost increases and improve this group’s quality of care, according to the paper.

Medicaid, according to the paper, plans to establish state programs that focus on a patient-centered medical home. In these “health homes,” states will integrate services from across the care spectrum including primary care, acute care, behavioral health care and long-term support and services. 

States adopting the program will be eligible to receive a 90% match rate for “health home” services during their first eight fiscal quarters, after which the state’s regular match rate will be observed, according to the paper. 

Current federal Medicaid law, section 1945, outlines those who are eligible to receive “health home” services as Medicaid beneficiaries with at least two chronic conditions, one chronic condition and high risk for another, or one serious and persistent mental health condition. Upon approval of the program, states will be allowed to determine more specifically who their target Medicaid population is. 

Missouri, Rhode Island, New York, Oregon, Iowa and North Carolina have all been approved for their State Plan Amendment (SPA), which outlines their target population, designation of providers, payment plans and implementation of health information technology. 

States participating in the health home program will also be required to report data that demonstrates the continuous improvement of their program. 

Read the full paper here

Written by Erin Hegarty

Erin Hegarty

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