The
Health Care Authority and the Department of Social and Health Services combined forces on July 1 to launch the first Health Homes in the state,
providing an enhanced delivery system for health care services needed by some
of the most vulnerable Medicaid clients.
The
project was planned with the help of a federal grant, and it has received solid
input and strong support from local health jurisdictions, health care providers
and advocates.
Health
Homes are focused on all Medicaid clients who have select chronic conditions
and who are at risk for costly and poorly coordinated health care services.
This includes the so-called “dual eligibles” – more than 100,000 Medicaid
clients who are also eligible for Medicare services, although the initiative is
targeting the most vulnerable, estimated at about 40,000 .
Health
Homes will be offered in 37 of 39 counties in the state, with a second
strategic approach planned in Snohomish and King counties next year.
Savings
are also anticipated, since the dual eligibles in Washington State amount to
only 13 percent of the state's client caseload -- but account for 30 percent of
the spending.
"Our
planning and projections have always been based upon a goal of improving care,
but we believe that an additional benefit of improved care and better health
outcomes can be cost savings in areas such as emergency room visits and
hospitalization." said Assistant DSHS Secretary Jane Beyer.
State
Medicaid Director MaryAnne Lindeblad said she was relieved to see the state's
plans coming to fruition after the long planning phase.
"We
have been working toward this for almost three years, and beginning July 1, it
will be a reality," she said. "This is testament to many, many local
health care providers and stakeholders."
The
first phase of Health Homes will include:
- Pierce
County, where the Health Homes will be provided by Coordinated Care,
Community Health Plan of Washington, United Healthcare, and Optum Regional
Support Network.
- Clark,
Cowlitz, Klickitat, Skamania, and Wahkiakum counties also will kick off
Health Homes on July 1, with the same group of providers.
- The
third region to launch services on July 1 is in the southeast corner of
the state -- Asotin, Benton, Columbia, Franklin, Garfield, Kittitas, Walla
Walla and Yakima counties. The same group of contractors will be available
there, along with the Southeast Washington Office of Aging and Long-Term
Care.
The
other Health Home contractors will be announced later this summer in three
other county groupings beginning October 1.Those regions include:
- Adams, Chelan, Douglas,
Ferry, Grant, Lincoln, Okanogan, Pend Oreille, Spokane, Stevens, and
Whitman
- Clallam, Grays Harbor,
Jefferson, Kitsap, Lewis, Mason, Pacific and Thurston
- Island, San Juan, Skagit
and Whatcom
The
Health Home provides for a care coordination function. Care coordinators may be
located in a primary care setting as well as community settings such as mental
health clinics or Area Agencies on Aging. The care coordinator works closely
with the Medicaid client and the client’s health care team to develop a Health
Action Plan that is designed to define steps toward improving their health and
remove barriers that could prevent achieving the action plan’s goals. The term
“Health Home” is broader than the concept of "medical homes"
and includes different levels and categories of health care -- substance abuse
treatment, mental health services and long-term care as well as primary care.
Apparently
successful bidders were announced last week for the second strategic phase of
the initiative, which will begin in April of 2014. That strategy will focus on
chronic care coordination in the state's two largest counties -- King and
Snohomish. (A news
release outlining plans for that phase of the initiative is available on
the Web.)
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