Maryland Medicaid Health Homes
Program Location:
Annapolis, MD
Payer Type:
Medicaid
Parent Program:
Payers:
Medicaid
Reported Outcomes
Description:
Maryland was approved for a 2703 Health Home State Plan Amendment in September of 2013. Health Homes for individuals with chronic conditions will augment the State's broader efforts to integrate somatic and behavioral health services. The program will target populations with behavioral health needs who are at high risk for additional chronic conditions, including those with serious persistent mental illness, serious emotional disturbance, and opioid substance use disorders. Health Homes will offer participants enhanced care coordination services from providers with whom they regularly receive care, including psychiatric rehabilitation programs, mobile treatment service providers, and opioid treatment programs. This is a community-based approach, not a residential program. Health Homes are designed to enhance person-centered care, empowering participants to manage and prevent chronic conditions in order to improve health outcomes, while reducing avoidable hospital encounters. Health Homes will provide six core services, as follows:
- Comprehensive Care Management
- Care Coordination
- Health Promotion
- Comprehensive Transitional Care
- Individual and Family Support
- Referral to Community and Social Support
Additional Maryland Health Home Resources:
Payment Model:
In addition to ongoing training and guidance from the Department, several forms of health information technology aid Health Homes in serving their participants, at zero or minimal cost to providers. This includes real-time hospital encounter alerts and pharmacy use data from the Chesapeake Regional Information System for our Patients (CRISP), as well as an eMedicaid online portal that acts as an enrollment, reporting, and tracking mechanism. Health Home providers receive a per member, per month reimbursement of $98.87, contingent upon minimum service delivery and adherence to all requirements.
Fewer ED / Hospital Visits:
ED utilization rates were highest during a participant’s first six months of enrollment, with 37.6 percent of total participants visiting the ED at least one time during that enrollment span. The ED utilization rate declined the longer those participants stayed in the Health Home program. Participants who were in a Health Home program between 19 to 24 months had the lowest ED utilization rate at 27.5 percent of participants with at least one ED visit during that enrollment span.
Cost Savings:
Average hospital inpatient health costs for participants in the Health Homes study group decreased from CY 2013 to CY 2015, while costs for participants in the comparison group increased during this study period. Total inpatient costs for the study group decreased slightly from $10,884 in CY 2013 to $10,125 in CY 2015, while total inpatient costs for the comparison group increased from $10,741 in CY 2013 to $11,821 in CY 2015.
Last updated February 2019
