Health Homes for Medicaid Enrollees with Chronic Conditions: A Conversation with CMS and States Regarding the ACA State Plan Option

There are at least 37 states that are planning or implementing health homes, medical homes, or advanced primary care for Medicaid populations. Many of these initiatives focus first on a subset of the chronically ill or high cost beneficiaries, with plans to expand to a broader population over time as desirable outcomes, such as improved quality of care and reduced health care costs, are realized.  The State Option to Provide Health Homes for Enrollees with Chronic Conditions, section 2703 of the Affordable Care Act (ACA), will provide enhanced federal funding for states that are planning to expand or implement a health home initiative that will serve individuals with chronic conditions – provided certain criteria are met.  This 120-minute webcast allowed states and stakeholders to hear from the Centers for Medicare & Medicaid Services (CMS) about the parameters of the legislation, and provided an opportunity for states to weigh in with CMS about how the State Plan Option might be constructed to best serve the needs of Medicaid populations. Participants heard from CMS, as well as several states that have initiatives underway, to stimulate thinking about how to improve or jumpstart their plans for improving care for Medicaid beneficiaries through health homes.

RESOURCE: Fast Facts on Five Featured Medical Home Initiatives

RESOURCE: Affordable Care Act, Section 2703

Speaker: Barbara Edwards, Director, Disabled and Elderly Health Programs Group, Center for Medicaid, CHIP, and Survey & Certification, CMS

CMS Presentation on Section 2703

Speaker: Jeffrey Schiff, MD, MBA, Medical Director, Office of Medicaid, Minnesota Department of Human Services
Populations Served and Services Provided: Lessons Learned from Minnesota

Speaker: Mike Fogarty, MSW, JD, Chief Executive Officer, Oklahoma Health Care Authority
Qualifying Practices as Health Homes: Lessons Learned from Oklahoma

Speaker: Denise Levis Hewson, RN, BSN, MSPH, Director of Clinical Programs and Quality Improvement, Community Care of North Carolina
Monitoring Care and Reporting Quality Measures:Lessons Learned from North Carolina

Speaker: Ann Torregrossa, JD, MLA, Director, Pennsylvania Governor’s Office of Health Care Reform
Payment Strategies: Tying Payment Structure to Services Delivered:Lessons Learned from Pennsylvania

Speaker: Elena Nicolella, MPH, Medicaid Director, Division of Health Care Quality, Department of Human Services
Managed Care Purchasing Strategies: Lessons Learned from Rhode Island