As an Apple Health provider, use this page to learn more about the Health Home program. This includes links to program resources and the Clinical Eligibility Tool—used to refer your clients to the program.
On this page
A health home is not a place. It is a set of services that support eligible clients, including help finding and getting long-term services.
The purpose of the Health Home program is to:
- Improve health and self-management of conditions.
- Provide transition and personalized care to help.
- Manage the progress of chronic disease.
The Health Home program provides the following services beyond the clinical services offered by a typical provider.
- Comprehensive care management
- Care coordination
- Health promotion
- Transitional planning and follow-up
- Individual and family support
- Referral to relevant community and social support services
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.
- Meet other criteria, including have a future medical cost risk score of 1.5.
Learn more about the Clinical Eligibility Tool.
The Health Care Authority (HCA) contracts with "lead" organizations. These lead organizations include:
- Managed care organizations
- Community based organizations
The lead organizations contract with care coordination organizations (CCOs) of which may include:
- Area agencies on aging.
- Chemical dependency providers.
- Child social service agencies.
- Community health centers.
- HIV/AIDs networks.
- Mental health clinics.
The CCO's provide health home services through care coordinators.
Care coordinators assist clients in:
- Identifying and meeting client-focus goals.
- Coordinating medical care.
- Organizing long-term services and supports.
- Connecting with behavioral health providers as appropriate.
Washington offers the Health Home program in all counties except King and Snohomish.
If you are a health care organization interested in participating in the Health Home program, please contact firstname.lastname@example.org to learn more about what is required.
- Measurement, Monitoring, and Evaluation of the Financial Alignment Initiative for Medicare-Medicaid Enrollees (January 4, 2016)
Preliminary findings from the Washington MFFS demonstration.
- Report on Early Implementation of Demonstrations under the Financial Alignment Initiative (October 15, 2015)