State Readies Health Home Project

California health officials expect to release within a week a fleshed-out proposal for a health home project that could reduce state costs and improve the lives of super users of the Medi-Cal health care system.

It’s a plan that won’t cost the state anything but has the potential to save quite a bit of taxpayer money. By coordinating the care for a small percentage of Californians with multiple chronic conditions, the state hopes to reduce the number of preventable emergency department visits and hospital admissions among that high-utilization population.  

“The Department of Health Care Services is preparing to release the Health Home Program Concept Paper 2.0, an expanded, more detailed concept paper, for stakeholder review in late March,” said Norman Williams, deputy director of public affairs at DHCS.

The federal government would pay 90% of the cost of implementing the program. The California Endowment, a private foundation, is expected to pick up the other 10% of the project’s cost.

The super users targeted by the project have complex, chronic medical problems and use a disproportionately large percentage of health services. According to Stateline, a publication of the Pew Charitable Trusts, just 5% of the nation’s 68 million Medicaid beneficiaries make up 60% of the program’s overall spending.

Fifteen other states have started health home programs, with about one million participants nationwide, according to CMS. California is one of eight states now planning to apply for a similar project.

The initial concept paper was released in November 2014. There are four draft goals for this high-risk chronic disease population:

• Improve care coordination;
• Integrate palliative care into delivery of primary care;
• Strengthen community linkages; and
• Strengthen team-based care, including use of promotores de salud, or community health workers.

The project is slated for rollout in January 2016, starting with the seven counties in the Coordinated Care Initiative and expanding to non-CCI counties in July 2016. The seven CCI counties are Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara.