In talking with lots of folks—they are confused about the term “health homes”. For some, when the term “health home” is used, they think it’s a residential facility (like a nursing home). Others think it’s a physical location where a person can go for health care needs, but really a health home is an approach to how health care is delivered.
A health home is a provider or a team of health care professionals that provide integrated health care. This means that if a person is participating in a health home, that person’s health care, from primary care doctor to dentist to behavioral health professional, all share the same information and coordinate treatment based on that information. Health homes operate under a “whole-person” philosophy – caring not just for an individual’s physical condition, but providing linkages to long-term community care services and supports, social services and family services. The integration of primary care and behavioral health services is critical to achievement of enhanced outcomes.
Under the Affordable Care Act, a health home provision [Sec. 2703 & Sec. 1945(e)] has been authorized that provides the opportunity for States to build a person-centered care system that results in improved outcomes for beneficiaries and better services and value for State Medicaid and other programs, including mental health and substance abuse agencies. The three types of health home provider arrangements described in the Act are:
- Designated providers, (physician, clinic, behavioral health organization)
- A health team which links to a designated provider
- A health team (physicians, nurses, behavioral health professionals)
Health homes are a critical tool in addressing the needs of people with mental health/substance use disorders. In fact, it is estimated that 70% of individuals with a significant mental health/substance use disorder had at least one chronic health condition, 45% have two, and almost 30% have three or more.
SAMHSA and the Centers of Medicare and Medicaid (CMS) have been collaborating on the implementation of the health home provision and are encouraging States to participate in an innovative way to deliver health care and improve health care quality.
CMS is requiring States to consult with SAMHSA as they develop their approaches to health homes. By consulting with SAMHSA, CMS and SAMHSA are assuring access to a wide range of physical health, mental health and substance use prevention, treatment, and recovery services in the health home plans. The approaches may include screening for alcohol and certain licit and illicit drugs, identifying available mental health and substance abuse services, discharge planning, care planning that integrates physical and behavioral health services, person/family-centered treatment planning, referral and linkage to other specialty health and behavioral health treatment, and supports that promote recovery and resiliency.
States can start participating in this new provision starting January 1, 2011. Preliminary guidance to assist States with implementing the behavioral health care aspects of health homes are online at SAMHSA’s new health home web-page.