South Dakota Health Homes

South Dakota's 2703 Health Home State Plan Amendment was approved 11/22/2013. South Dakota is implementing Health Homes to improve health outcomes and experience of care for eligible Medicaid recipients, while also realizing cost savings from better coordinated care for that population.

The work began as a recommendation of the Medicaid Solutions Workgroup.  The Medicaid Solutions Workgroup, convened by Governor Dennis Daugaard during legislative session 2011,  was tasked with identifying ways Medicaid could realize cost savings and better serve recipients.   The Final Report of the Medicaid Solutions Workgroup can be viewed here.

South Dakota has two types of Health Homes -- those led by Primary Care Providers and those led by a Community Mental Health Centers -- to serve Medicaid recipients with complex health care needs resulting in high costs to Medicaid. Individuals who are eligible for these two health homes include:

1. Medicaid recipients with two or more chronic conditions or recipients with one chronic condition who are at risk for a second chronic condition.
   1. Chronic conditions include: Mental Health Condition, Substance Use Disorder Asthma, COPD, Diabetes, Heart Disease, Hypertension, Obesity, Musculoskeletal and Neck/Back disorders. 
   2. At-risk conditions include: Pre-Diabetes, tobacco use, Cancer, Hypercholesterolemia, Depression, and use of multiple medications (6 or more classes of drugs). 
2. Recipients who have a Severe Mental Illness or Emotional Disturbance