Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
Health Home
As an Apple Health (Medicaid) provider, use this page to learn more about the Health Home program and find Health Home program resources.
On this page
The Health Home program is a partnership between HCA, the Centers for Medicare and Medicaid Services (CMS) and the Department of Social and Health Services (DSHS).
What is the Health Home program?
A Health Home is not a place. It is a set of services supporting eligible clients.
The Health Home program helps clients:
- Develop a person-centered health action plan
- Improve self-management of chronic conditions
- Ensure care coordination and care transitions
The Health Home program provides the following specific services:
- Comprehensive care management
- Care coordination
- Health promotion
- Comprehensive transitional care
- Individual and family support
- Referral to community and social support services
Client eligibility
Apple Health clients of all ages, including Medicaid/Medicare dual eligible clients, may be eligible for the Health Home program if they:
- Have at least one chronic condition and are at risk for another
- Have a PRISM predictive risk score of 1.5 (per WAC 182-557-0225)
- Meet Apple Health (Medicaid) eligibility criteria
Additional requirements do apply.
Program providers
Lead organizations
The Health Care Authority (HCA) contracts with "lead organizations", which include:
- Managed care organizations (MCO)
- Qualified community-based organizations
The lead organizations contract with care coordination organizations (CCO), such as:
- Area Agencies on Aging (AAA)
- Child social service agencies
- Community health centers
- HIV/AIDs networks
- Mental health clinics
- Substance use disorder (SUD) specialists
Together they provide the Health Home services through qualified care coordinators.
Health Home dashboard
The Health Home dashboard represents the collaborative work between HCA and the Department of Social and Health Services Aging and Long-Term Support Administration (DSHS-ALTSA) to optimize this service as part of the overall strategy towards a healthier Washington.
The dashboard provides visual information for users to see available Health Home services and service providers in their area. We update this information quarterly to remain responsive to client and potential-client needs.
Becoming a Health Home care coordination organization
If your organization is interested in becoming a care coordination organization (CCO), contact Health Homes to receive information about our lead organizations, which you can contact to get started.
Health Home resources
The following Health Home resources are available for health professionals involved with the Health Home program.
- Information about the Health Home program
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Materials and resources that can be used to educate providers and clients about the Health Homes program.
- Care coordinator guides and instructions
- Clinical Eligibility Tool
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- Clinical Eligibility Tool
- Clinical Eligibility Tool instructions
- How the medical expenditure risk score is calculated
- Forms
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The following forms are available in Word and PDF format and may be available in a variety of languages including Cambodian, Chinese, Korean, Laotian, Russian, Somali, Spanish, and Vietnamese.
- Health Action Plan (HAP)
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- Implementation (canonical) guide (revised June 2020)
- Reports
- Enrollment materials
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- Health Home Booklet (available in 15 languages)
- Tribal Health Home materials
- Contracts and rate information
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Example contracts and information about rate structure and payment rates for the Health Home program.
- Care coordinator training
Contact
Email: Health Homes
For information on options counseling
Phone: 1-855-567-0252