What Are Health Homes?
By Rebecca A. Clay
For people with serious or multiple chronic health conditions, a primary care physician often isn’t enough. To meet all their needs, they may also see several specialists. And that can get complicated.
“Trying to navigate the health care system is like trying to find your way through a tangled maze,” said Charles Ingoglia, M.S.W., Vice President for Public Policy at the National Council for Community Behavioral Healthcare. “Sometimes, doctors don’t have time to talk to each other or share information.”
“Health homes” are an attempt to change that. “And we need to clarify what a health home is, too,” said John O’Brien, M.A., Senior Advisor for Health Financing at SAMHSA. “Some folks are concerned that when you’re talking about homes, you’re talking about residential programs.” Not so, Mr. O’Brien explained.
Rather than being a physical place, health homes are a strategy for helping individuals with chronic conditions manage those conditions better.
An eligible individual—for example, a person with diabetes and a mental illness—selects a provider or team of health care professionals to be his or her health home. That home then becomes accountable for all the individual’s care, including the following:
- Manage and coordinate all of the services the person receives from multiple providers.
- Promote good health.
- Help with transitions from one kind of setting to another.
- Provide support to both the individual and her family members.
- Offer referrals to community and social support services.
Health information technology helps link all of these services together.
The health homes provision is especially good news for people with mental health and substance use disorders, said Rita Vandivort-Warren, M.S.W., a public health analyst in the Department of Services Improvement at SAMHSA’s Center for Substance Abuse Treatment.
“Those with these chronic illnesses tend to have more complex, long-standing needs and more variety of different providers involved,” she explained. “In other words, they have to go to many different providers who may not communicate with each other and who never see the whole person, only the illnesses they treat.”
The new provisions will allow Medicaid to reimburse providers for the time they spend on such vital tasks as coordinating interdisciplinary care, whether in person or virtually, or meeting with family members to help support an individual’s recovery.
States can begin offering the health homes option in January 2011. “We’ve heard informally that a lot of states are interested,” said Ms. Vandivort-Warren. The legislation features a “sweetener”—a 90 percent Federal match for the first 2 years—to encourage states to add health homes to their list of benefits, she said. States interested in including health homes in their Medicaid programs must submit a state plan amendment to the Centers for Medicare and Medicaid Services (CMS).
SAMHSA will be providing assistance to states on prevention and treatment services for those with mental and substance use disorders. In fact, the legislation requires states to consult with SAMHSA on their proposals’ behavioral health aspects.
For more information on health homes, visit http://www.healthcare.gov.