States Slow To Establish ACA’s ‘Health Homes’ for Mental Health Care

Although many states have expressed interest in establishing "health homes" for those with mental illnesses, tight budgets and focus on other Affordable Care Act requirements have stalled efforts to do so in all but 10 states, Politico reports.

The health homes provide Medicaid beneficiaries with mental illness or other chronic conditions with a coordinated team of health care providers who span the health care system. The idea is to integrate participants' behavioral and primary care. Under the ACA, states can submit a blueprint for implementing a health home to HHS for approval and funding.

However, Politico reports that of the 10 states with federally approved plans, only six -- Idaho, Missouri, New York, Ohio, Oregon and Rhode Island -- have established health homes targeted toward patients with serious and persistent mental illness or substance use disorders.

According to Politico, although there is widespread state interest in the program, establishing health homes is a complicated and labor-intensive process. Even those states that have implemented health homes have encountered communication problems between different sectors of the health system, difficulty encouraging participants to use new technology and problems educating providers about the program's purpose.

Chuck Ingoglia, vice president of public policy for the National Council for Community Behavioral Healthcare, cited states' efforts to implement other parts of the ACA, such as Medicaid expansion and enrollment, as the primary reason for the health home delay. "To be honest, I think part of it is just state bandwidth," he said, adding "And part of it is, how many changes can we undertake simultaneously?" (Smith, Politico, 2/20).