Two state agencies will combine forces on July 1 to launch the state’s first Health Homes — an enhanced delivery system for health care services.
The Department of Social and Health Services and the Health Care Authority have been collaborating on the initiative with federal partners for almost three years, and the project has received solid input and strong support from local health jurisdictions, health care providers and advocates.
The initial strategy focuses on all Medicaid clients in 37 of 39 counties who have select chronic conditions and who are at greater risk for costly and poorly coordinated health care services. A second strategic approach is planned in the remaining two counties — Snohomish and King — but that phase won’t begin until next year.
Both phases are open to all qualifying Medicaid clients, including a special population — those Medicaid clients who are also eligible for Medicare, or “dual eligibles.” More than 100,000 of Medicaid clients fall into that category, and the twin strategies will primarily target about 40,000 of the most vulnerable.
The DSHS and HCA collaboration has been under way since 2011, when the state was among 15 selected to map out improved coordination between Medicaid and Medicare, as well as care improvements that would focus on system integration and individuals with chronic conditions who would benefit from closer contact with the health care system overall.
The Health Homes initiative anticipates some savings, as well as improved care and healthier participants. Dual eligibles in Washington State currently comprise only 13 percent of the state’s client caseload — but account for 30 percent of the spending.
“Our planning and projections have always been based upon a goal of improving care, but we believe that an additional benefit of improved care and better health outcomes can be cost savings in areas such as emergency room visits and hospitalization.” said DSHS Assistant Secretary Jane Beyer.
State Medicaid Director MaryAnne Lindeblad said she was relieved to see the state’s plans coming to fruition after the long planning phase. “This is testament to the hard work of many, many local health care providers and stakeholders.”
The first phase of Health Homes will include:
- Pierce County, where the Health Homes will be provided by Coordinated Care, Community Health Plan of Washington, United Healthcare, and Optum Regional Support Network.
- Clark, Cowlitz, Klickitat, Skamania, and Wahkiakum counties also will kick off Health Homes on July 1, with the same group of providers.
- The third region to launch services on July 1 is in the southeast corner of the state — Asotin, Benton, Columbia, Franklin, Garfield, Kittitas, Walla Walla and Yakima counties. The same group of contractors will be available there, along with the Southeast Washington Aging and Long-Term Care.
The other Health Home contractors will be announced later this summer in three other county groupings beginning October 1. Those regions include:
- Clallam, Grays Harbor, Jefferson, Kitsap, Lewis, Mason, Pacific and Thurston
- Island, San Juan, Skagit and Whatcom
- Adams, Chelan, Douglas, Ferry, Grant, Lincoln, Okanogan, Pend Oreille, Spokane, Stevens, and Whitman
The Health Home provides for a care coordination function. Care coordinators may be located in primary care settings, as well as community settings such as mental health clinics or Area Agencies on Aging. The care coordinator works closely with the Medicaid client and the client’s health care team to develop a Health Action Plan that is designed to define steps toward improving their health and removing barriers that could prevent achieving the action plan’s goals.
The term “Health Home” is broader than the concept of “medical homes” and includes different levels and categories of health care — substance abuse treatment, mental health services and long-term care as well as primary care.