Under the Affordable Care Action Section 2703, the Centers for Medicare and Medicaid Services (CMS) is offering states an option to provide health homes for members with chronic conditions, with enhanced federal support. This option covers the enhanced integration and coordination of primary, acute, behavioral health, and long-term services and supports for persons across the lifespan with chronic illness. It provides an opportunity to build a person-centered system of care that achieves improved outcomes for beneficiaries and better services and value for State Medicaid programs. This provision supports CMS’s overarching approach to improving health care through the simultaneous pursuit of three goals: improving the experience of care; improving the health of populations; and reducing per capita costs of health care (without any harm whatsoever to individuals, families, or communities).

To take advantage of this opportunity, states must submit a Medicaid State Plan Amendment and before doing so BMS would like to obtain as much stakeholder input as possible. A kick-off stakeholder meeting was held on August 16 and four work groups have been set up to address various aspects of the health home initiative. The attached graphic provides a summary of the charge for each group. If you would like to participate, contact webmaster@wvhealthimprovement.org.

The purpose of the pilot is to gain experience with implementation of the medical home model in West Virginia and to determine whether the model demonstrates improvement in clinical process and outcomes measures as well as a reduction in overall cost of care. The pilot is divided into two phases. The first phase is the provider training phase; the second phase is the data collection phase to determine impact.