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The Missouri legislature first promoted medical homes with the passage of SB577 of the 2007 Session Laws, known as the Missouri Health Improvement Act, which including a requirement that MOHealthNet (Medicaid) provide all beneficiaries with a health care home (left undefined in the legislation).
The state is also supporting the Missouri Foundation for Health’s (MFH) Patient-centered Medical Home Collaborative. MOHealthNet is not a participating payer (the program is currently limited to Anthem Blue Cross Blue Shield and United Healthcare), but practices in the MFH medical home program and MOHealthNet health home program will both participate in the same learning collaboratives. MFH describes the two programs as, “separate, but coordinated.” Additional information on the Missouri Medical Home Collaborative can be found in the RFA and Questions and Responses.
Federal Support: On October 20, 2011, Missouri became the first state to receive CMS approval for a state plan amendment to implement Affordable Care Act Section 2703 Health Homes for enrollees with chronic conditions. Missouri’s first approved SPA targets behavioral health patients served by community mental health centers. On December 22, 2011, CMS approved a second health home SPA focusing on patients with physical health conditions served by Federally Qualified Health Centers, Rural Health Centers and hospital-based primary care clinics. To learn more about Section 2703 Health Homes, visit the CMS Health Homes webpage.
Last updated: May 2012
| Forming Partnerships |
SB577 of the 2007 Session Laws created an 18 member MOHealthNet Advisory Committee to oversee the MOHealthNet program. The Advisory Committee includes government, provider (including physicians, non-physicians and dentists), hospital, and consumer representation.
The Missouri Department of Mental Health acknowledges the following partners in developing Affordable Care Act Section 2703 Health Homes:
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| Defining & Recognizing a Medical Home |
Definition: Under Missouri’s state plan amendment to provide health homes for MOHealthNet enrollees served by community mental health centers (CMHCs), health homes must provide accessible, coordinated, person-centered, culturally-competent, and linguistically-capable care that is quality driven and cost effective.
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| Aligning Reimbursement & Purchasing |
ACA Section 2703 Health Home State Plan Amendment – Community Mental Health Centers: Health home teams in community mental health centers receive a combined $78.74 per-member per-month payment to fund the services of a nurse care manager, a primary care physician consultant, a health home director, and health home administrative support. MOHealthNet will review the payment methodology after 18 months (including an exploration of whether to tier the payment) and will adjust annually according to the consumer price index (CPI).
Payments for health home enrollees participating in a managed care plan will be made directly from Medicaid to the health home provider. |
| Supporting Practices |
All MOHealthNet providers have access to a web-based HIPAA-compliant electronic medical record program for their Medicaid patients, known as CyberAccess.
ACA Section 2703 Health Home State Plan Amendment – Community Mental Health Centers: Missouri state agencies and health care foundations will join providers in spending over $1.5 million to cover training and technical assistance during practice transformation.
Participating community mental health centers will participate in a number of statewide learning activities, including learning collaboratives, monthly practice team calls to reinforce learning sessions, practice coaching, and monthly practice reporting (data and narrative) and feedback.
Learning activities will focus on teaching practices to coordinate patient- and family-centered, quality-driven, cost-effective, culturally and linguistically appropriate care (including the use of health technology).
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| Measuring Results |
ACA Section 2703 Health Home State Plan Amendment – Community Mental Health Centers: MOHealthNet will use claims, a disease registry, a web-based electronic medical record, monthly health home reports, and annual status reports to measure success in eight specific goals specified in their first health home state plan amendment:
Missouri will assess quality improvement and clinical outcome measures at both the practice and aggregate level. |
