Health Homes

​For more information on this partnership with CMS and DSHS, visit the DSHS Office of Service Integration website.

Email us at healthhomes@hca.wa.gov

What is a Health Home Program?

The Health Home Program was created by Affordable Care Act (ACA) section 2703. It allows states to provide Health Home services and care coordination to high cost high risk Medicaid and Medicare/Medicaid (duals) eligible clients. Its purpose is to reduce duplication of services and provide smoother transition and more personalized care to help reduce the progression of chronic disease, reduce inappropriate emergency department utilization and preventable hospital readmissions, and improve health and self-management of conditions.

As defined by the Centers for Medicare and Medicaid (CMS), a Health Home provides six specific services beyond the clinical services offered by a typical provider.

  • Comprehensive care management
  • Care coordination and health promotion
  • Comprehensive transitional care and follow-up
  • Patient and family support
  • Referral to community and social support services
  • Use of information technology to link services, if applicable

The Health Care Authority (HCA) and Department of Social and Health Services (DSHS) approve "Lead" Organizations. These Leads include Managed Care Organizations, as well as Community Based Organizations. The Leads contract with Care Coordination Organizations (CCOs) too and may include mental health clinics, area agencies on aging, chemical dependency providers, HIV/AIDs networks, child social service agencies, and community health centers. The CCO's provide Health Home services through a Care Coordinator. Care Coordinators assist clients in coordinating medical care, long-term services and supports, and behavioral health as appropriate. The client and Care Coordinator can meet at a location of the client's choice: a clinic, the patient's home, or other community location. Washington offers the program in all counties except King and Snohomish.

Health Homes Phase-Out Plan

The 2015-2017 Omnibus Operating budget did not authorize any funding for Health Care Authority's (HCA) Health Home program past December 31, 2015. Because available funds to support the Health Home benefit have not been authorized, HCA will be terminating the program at the end of 2015. The Health Home program is operated under two different mechanisms — a State Plan Amendment (SPA) and a Fee-for-Service Financial Alignment Demonstration Final Demonstration Agreement. Both require a phase-down or phase-out plan.

The following three files: Draft Health Homes Phase-Out Plan, Draft End of Health Homes Client Notice and Draft Health Homes Phase-Out Timeline are available for public review and comment. Comments on the phase-out plan, timeline and client notice may be sent to Becky McAninch-Dake at Becky.McAninch-Dake@hca.wa.gov by September 21, 2015. Comments will be compiled and sent to CMS with the draft phase-out plan on September 23, 2015.

Care Coordinator Training

Contracts

Forms

Enrollment Material

Lead Communication

Reports

Resources