What are Health Homes?
A simple answer to the question, "What is a Health Home?" is, a way to centralize the coordination of care provided to individuals who utilize Medicaid. A Health Home would include a large regional area. For example, one Health Home would work to coordinate care for the entire Nassau County area.
What does it mean to coordinate care?
Similar to how a case manager will work with individuals to ensure their needs are met, the Health Home will assist in assuring that the services that individuals need are provided for. Health Homes will not directly provide individuals with services but, refer individuals to places where those services are provided. A Health Home is a central coalition of referral services (hospital care, mental health services, substance abuse services, private medical doctors, etc.) where individuals can be provided information as to where they can receive services from.
Currently, some individuals are unaware of how to utilize health services and see the hospital emergency room as their first line of health care. This creates a problem due to the expensive costs involved with an emergency room visit. For example, an individual who has a urinary track infection may seek medical attention through a hospital emergency room rather than a primary medical doctor. A doctor visit and the expense of medications to cure the urinary track infection would be significantly less than the expense of an emergency room visit.
The concept of a Health Home will allow individuals the ability to access services with out the need to use the hospital emergency room. Again, Health Homes will not provide services for individuals but, provide a list of places where they can receive the appropriate health care.
Why is this being done?
New York State's 2011 budget resulted in a deficit of $10 billion dollars with a large contributing factor being Medicaid expenses. It was founded that although there are high Medicaid expenses, only a small amount, approximately 20% of all individuals currently on Medicaid, use approximately 75% of the resources available.
It is estimated that 300,000 people use up to $5 billion dollars in resources every year. Despite the high expenditures, the money that is spent is usually not spent well. This is can be obvious as we unfortunately still see individuals who are diagnosed with a mental illness die prematurely (approximately 25 years earlier) than individuals who do not carry a diagnosis. We also see that $800 million dollars were spent on individuals who were inappropriately discharged from hospital to only be re-admitted in less than 30 days from their discharge.
Overall, Health Homes are designed to improve the health of the current users of Medicaid, Improve the experience of the care that individuals are provided, and ultimately reduce the overall cost of medical expenses. In theory, under a Health Home, individuals who currently do not have access to adequate health care will be provided with the level of care that they need. This will hopefully improve the quality and longevity of life for individuals currently on Medicaid.
What to expect:
Health Homes are not physical places where a consumer would go or live to receive services but rather describes a large network of care designed to meet: mental health, physical health, and substance abuse needs. Individuals will be assigned a care manager to assist them in coordinating the level of care that they need. Care managers will also work to ensure that when an individual is discharged from a hospital, the necessary aftercare will be provided to prevent re-admission.
The use of electronic record keeping (EHR - Electronic Hear Record) will allow various agencies to assist in the coordination of care. For example, the records of individuals who were recently hospitalized will be submitted electronically to a database that will be available to other members of their care team such as their PROS advisor, their psychiatrist, and their medical doctor. This will increase the ability to coordinate the appropriate level of care for each individual.