First interim evaluation of California's Health Homes Program (HHP)
- Collection:
- Health Policy and Services Research
- Author(s):
- Pourat, Nadereh, author Chen, Xiao , author O'Masta, Brenna, author Haley, Leigh Ann, author Warrick, Anna, author Zhou, Weihao, author Yao, Hanqing, author
- Contributor(s):
- UCLA Center for Health Policy Research, issuing body.
- Publication:
- Los Angeles, CA : UCLA Center for Health Policy Research, September 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Medicaid Multiple Chronic Conditions Patient-Centered Care Program Evaluation California United States
- Genre(s):
- Technical Report
- Abstract:
- The California Department of Health Care Services (DHCS) implemented the Medi-Cal Health Homes Program (HHP) to serve eligible Medi-Cal beneficiaries with complex needs and chronic conditions. HHP was authorized under California Assembly Bill 361 and approved by Centers for Medicare and Medicaid Services under Section 2703 of the 2010 Patient Protection and Affordable Care Act. The overarching goal of HHP was to achieve the "triple aim" of better care, better health, and lower costs by improving member outcomes through care coordination and reducing avoidable health care costs. HHP was designed to provide six core services for eligible enrollees: (1) comprehensive care management; (2) care coordination; (3) health promotion; (4) comprehensive transitional care; (5) individual and family support; and (6) referral to community and social support services. DHCS selected 12 California counties where 16 Medi-Cal managed care plans (MCPs) would implement HHP for MCP enrollees who met certain chronic condition and acuity criteria. HHP was implemented in phases by county groupings and two subsets of enrollees, with the first group implementing in July 2018 and the last group implementing in September 2020. Subsets of enrollees included those with chronic physical health conditions or substance use disorders (SUD) referred to as SPA 1 (State Plan Amendment 1) and those with severe mental illness (SMI) referred to as SPA 2. MCPs implemented SPA 2 six months after SPA 1 within each county grouping. DHCS published a program guide to ensure uniform HHP implementation, delivery of services, and reporting across all MCPs. MCPs were expected to contract with Community-Based Care Management Entities (CB-CMEs), or in instances where contracting with local CB-CMEs was not feasible, to deliver services directly to HHP enrollees. CB-CMEs could include primary care providers (PCPs), Federally Qualified Health Centers (FQHCs), and other service providers. CB-CMEs could also work with Community Based Organizations (CBOs) to provide linkages to community and social support services, as needed. This evaluation report is the first of a series of three planned evaluation reports of HHP and focuses on the initial implementation efforts and infrastructure development of HHP MCPs, health status and utilization of enrollees prior to HHP implementation, as well as some early trends for key health outcomes and utilization metrics for Group 1 SPA 1 enrollees.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (292 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101773772 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101773772