1 / 14

Section 2703 Health Homes Overview

Section 2703 Health Homes Overview. Charles A. Townley Policy Analyst National Academy for State Health Policy June 14 th , 2012. Section 2703 of the Affordable Care Act (ACA). Created Section 1945 of the Social Security Act

olisa
Download Presentation

Section 2703 Health Homes Overview

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Section 2703 Health Homes Overview Charles A. Townley Policy Analyst National Academy for State Health Policy June 14th, 2012

  2. Section 2703 of the Affordable Care Act (ACA) • Created Section 1945 of the Social Security Act • “State Option to Provide Coordinated Care through a Health Home for Individuals with Chronic Conditions” • Authorized states to submit a Medicaid State Plan Amendment (SPA) to implement health homes • Enhanced Federal Medical Assistance Percentage (FMAP) • 90 percent for the first eight quarters • Applies only for the specific health home services • Planning Grants: • Each state eligible for a planning grant up to $500,000 – allows state to draw regular FMAP for health home planning activity. • Two-page Letter of Request

  3. What are Health Homes? • Health Home Services: • Comprehensive Care Management • Care Coordination • Health Promotion • Comprehensive Transitional Care • Individual and Family Support • Referral to Community and Social Support Services • Better Coordination/Integration of Primary Care, Behavioral Health, and Long-Term Care • State Medicaid Director Letter released November 16, 2010 (SMDL #10-024)

  4. Section 2703 Health Home State Plan Amendments (SPAs) AK VA WA VT ME ND MT OR ID MN NH MA NY WI SD MI WY RI CT PA IA NJ NE NV OH UT IN DE IL MD CO CA WV DC KS MO KY NC TN AZ OK SC AR NM GA AL MS TX LA FL HI Approved: 5 States (7 SPAs) Submitted: 4 States Planning Grant:14 States and Washington, D.C. 4 As of June 1, 2012

  5. Eligibility • Medicaid enrollees with: • One serious and persistent mental health condition • Two or more chronic conditions • One chronic condition with the risk of developing a second • Eligible Conditions listed in the ACA: • Mental Health Condition; Substance Use Disorder; Asthma; Diabetes; Heart Disease; Overweight (defined as BMI>25) • States can include additional conditions subject to approval

  6. Financing • States have flexibility in developing payment methodologies • ACA identifies tiered payments for provider capabilities or patient complexity • States may propose alternatives. • Per-Member Per-Month payments the most common approach taken thus far.

  7. NASHP’s Learning Community • Section 2703 Learning Community part of 3rd Medical Home Consortium, supported by The Commonwealth Fund. • Six states: • Colorado • New Mexico • New York • North Carolina • Oklahoma • Washington

  8. Learning Community (cont.) • Series of six technical assistance webinars • Identified five salient issues important for states to keep in mind when pursuing the Health Home Option • Coordination with Existing Programs • Financing and Payment • Integrating Behavioral and Physical Health • Sharing Data across Providers • Health Home Evaluation • Upcoming NASHP Publication

  9. Coordination with Existing Programs • Building on existing state programs • Developing new programs • Managed Care Plans and Health Homes

  10. Financing and Payment • Payment Methodologies • Health home infrastructure and training • Examples of infrastructure: • Staff (e.g., Case Managers) • Systems (e.g., Health Information Technology) • How states are paying for managed care enrollees

  11. Integrating Behavioral and Physical Health • Models of Integration • Coordinated Care: Behavioral health working with primary care • Integrated Care: Behavioral health working within and as a part of primary care Source: Chris Collins et al., Evolving Models of Behavioral Health Integration in Primary Care (New York, NY: Milbank Memorial Fund, May 2010

  12. Sharing Health Data • Sharing data across providers and health systems • Using health information technology (HIT)

  13. Health Home Evaluation • ACA requires two reports to Congress (2014 and 2017) • Hospital Admissions • Emergency Department Utilization • Skilled Nursing Facility Admissions • Hospital Re-admissions; Disease Management; Care Coordination; Cost Savings • State-specific Goals

  14. SAVE THE DATE My e-mail: ctownley@nashp.org SAVE THE DATE: National Academy for State Health Policy 25th Annual State Health Policy Conference October 15-17, 2012 Baltimore, MD Visit: www.nashp.org Follow us on Twitter: @nashphealth

More Related