Missouri Health Homes Program
Program Location:
Jefferson City, MO
Payer Type:
Medicaid
Partner Organizations:
MO HealthNet
Parent Program:
Payers:
Medicaid
Reported Outcomes
Description:
Missouri has two approved 2703 Health Home State Plan Amendments. The first State Plan Amendment was approved in October of 2011 and covers individuals with a Serious and Persistent Mental Illness (SPMI), mental health or substance abuse disorder plus a chronic condition, Mental Health or Substance Abuse Disorder plus tobacco use
The second State Plan Amendment was approved in December of 2011 and covers individuals with at least two of the following:asthma, cardiovascular disease, diabetes, developmental disabilities, overweight (BMI > 25%) OR one of the previous chronic conditions and at risk of developing another. At risk criteria include: tobacco use or diabetes.
Missouri will use this initiative to reduce inpatient hospitalization and emergency room visits, enhance the amount of primary care nurse liaison staffing available at community mental health centers, add primary care physician consultation, and enhance the State’s ability to provide transitional care between institutions in the community.
Related News & Resources
Payment Model:
Both SPAs will incorporate:
Clinical care management PMPM payment
Interested in shared savings strategy and performance incentive payment - both for Home Health providers and for Medicaid - and will result after initial approval
Fewer ED / Hospital Visits:
Department of Mental Health and MO HealthNet (November 2013) report summarizes the clinical outcomes and system impact achieved during the first 18 months of the program
- 12.8% reduction in hospital admissions
- 8.2% reduction in ED use
Improved Health:
Department of Mental Health and MO HealthNet (November 2013) report summarizes the clinical outcomes and system impact achieved during the first 18 months of the program
- Improvement in diabetes control measures from:
- 22% to 47% for LDL
- 27% to 59% for blood pressure
- 18% to 53% for A1c
- Improvement in the percentage of adutls with:
- cardivascular disesase whose LDL levels are in control
- hypertension whose BP levels are in control
- Increase in percentage of enrollees with complete metabolic screens (12% to 61% for adults, 9% to 56% for children)
- Improvement in patient follow-up and medication reconciliation following a hospital admission
Cost Savings:
Department of Mental Health and MO HealthNet (November 2013) report summarizes the clinical outcomes and system impact achieved during the first 18 months of the program
- Reduction of $127.55 PMPM in hospital and ED visit costs
- Overall cost savings of approximately $2.9 million
- Total net cost savings to Medicaid, when including dual eligibles, was more than $27 million after one year of enrollment
Other Outcomes:
The Year 5 report from the Urban Institute’s program evaluation also found reductions in Medicaid spending, particularly for dually eligible beneficiaries. The report found greater spending reductions for individuals with longer program exposure (more than nine months).
Data Source(s):
Report to Congress (May 2018)
Last updated March 2019
