Are Health Homes Working? The Payer Perspective
OPEN MINDS Daily Executive Briefing | Monica E. Oss June 26, 2014
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Lots of state Medicaid plans have moved ahead with health homes. Currently health homes are active in 27 states with over one million enrollees (see 27 States With Medicaid Health Homes Initiatives; Over 1,000,000 Complex Consumers Enrolled As Of March 2014). Lots of activity. Lots of spending. The big question – are health homes working?
I had a chance to get an update on the longest-running health home initiatives – from the Medicaid payer perspective – at the 2014 OPEN MINDSPlanning & Innovation Institute (see A Health Home Update: Where Are Payers & Policymakers With Health Homes?). Dorn Schuffman, Senior Consultant & Coordinator Primary/Behavioral Health Care Integration Unit, Missouri Department Of Mental Health, and Paul A. Choquette, M.A., Senior Healthcare Delivery Systems Specialist, Xerox State Healthcare, Rhode Island Executive Office Of Health & Human Services, provided an update on the performance of health homes in those two states.
Mr. Schuffman noted that in an effort to improve performance via the health home model, the Missouri program uses a population management approach focusing on a broad array of factors such as use of medications, key metabolic indicators, hospital (and ER) usage, and psychiatric rehabilitation and recovery. In his discussion, he called out one key improvement – the increase in prompt follow-up with consumers following hospital discharge. What is the bottom line? $2.4 million in initial first year savings.
Providing an update from Rhode Island, Mr. Choquette noted that health home programs in the state have proven to be flexible, with high member satisfaction and high functional outcome measures. The programs have produced a reduction in hospital spending. From 2010 through 2013, inpatient and residential expenses have fallen from $22.1 million per year, to $14.8 million per year. And, average length-of-stay (LOS) has fallen from 12.4 days in 2010, to 6.85 days in 2013.
Ready to start the discussion about both moving to a health home? Check out these resources from the OPEN MINDS Industry Library:
- Medical Home V. Health Home – Confused?
- Meeting The Challenge With Health Homes
- What Matters In Making Health Homes Sustainable
- State-by-State Health Home State Plan Amendment Matrix: Summary Overview
- A Health Home Update – Health Homes Go Private
Also, for a deeper dive, make sure to catch the upcoming executive web briefing, A New Approach For People With Complex Service Needs: The Behaviorally-Focused Medical Home on July 24, at 12:30 p.m. (EST). The web briefing features James Schuster, M.D., Chief Medical Officer of Community Care Behavioral Health – who leads a health home initiative for consumers with serious mental illnesses in Pennsylvania. In the web briefing, Dr. Schuster will discuss the key elements in successfully managing a behaviorally-focused medical home and a review of the early research medical home effectiveness.