Tennessee Health Homes
Program Location:
310 Great Circle Rd.
Nashville, TN 37243
Payer Type:
Medicaid
Parent Program:
Payers:
Medicaid
Reported Outcomes
Description:
Tennessee's State Plan Amendment was approved in 2017 for the creation of a statewide SMI health home model. The program was designed for Adults with SMI (serious mental illness) and children with SED (severe memotional disturbance).
Tennessee provides Health Home services to adults with serious mental illness (SMI) and children with Serious Emotional Disturbance (SEO). The goal of the Health Home program is to meet the needs of these beneficiaries by:
1. Improving the quality of care that beneficiaries receive during the management of their illnesses.
2. Improving efficiency and decreasing the cost of care that beneficiaries receive by improving coordination of care between beneficiaries, their behavioral and physical health providers, and their social supports.
3. Improving the overall beneficiary experience of care.
In Tennessee's Health Home model, a Health Home will consist of a care coordination team embedded in a qualifying provider type. At the core of the care coordination team will be a clinical care coordinator and a case manager, with access to therapeutic staff on site or by affiliation. The Health Home will be responsible for enrolling all beneficiaries attributed to it, and meeting their needs by providing them with Health Home activities, as defined in this document, as they require.
Payment Model:
In order to receive a per member per month payment (PMPM), Health Homes must perform and submit claims for at least one of these activities for a beneficiary each month. We refer to this as an activity payment.
