The Affordable Care Act of 2010 gave state Medicaid agencies the option of creating Health Homes to provide a comprehensive system of care coordination for Medicaid individuals with chronic conditions. West Virginia chose to participate in the Health Homes program and will receive an enhanced federal match of 90% for eight quarters. The Health Homes initiative provides a place for individuals to have their health care needs identified and to receive the medical, behavioral health and related social services and supports they need in a coordinated manner that recognizes all of their needs as individuals and as patients. Health Home services include comprehensive care management, care coordination, health promotion and community and social support services. A Health Home is not a place to live.
The goals of the Health Homes program include:
- Helping members experience longer periods of stability of their condition
- Decreasing the use of medications and increasing compliance
- Informing patients of their hepatitis risk and status and educating about its spread; and
- Helping identify substance abuse more effectively and reducing ER visits and hospitalizations
West Virginia currently has two Health Homes:
The first Health Home was started in July 2014 in a six county area in southern West Virginia for eligible Medicaid members with bipolar disorder and at risk of having or having Hepatitis B or C. In April 2017 this Health Home expanded statewide. More information about this Health Home can be found be clicking on the following link: Behavioral Health Health Home.
The second Health Home started in April 2017 as a pilot program designed for eligible Medicaid members with pre-diabetes, diabetes or obesity and at risk of having anxiety or depression. This pilot program is in a 14 county region: Boone, Cabell, Fayette, Kanawha, Lincoln, Logan, Mason, McDowell, Mercer, Mingo, Putnam, Raleigh, Wayne and Wyoming. More information about this Health Home can be found by clicking on the following link: Diabetes Health Home.
Expanded and New Health Homes Program Information for Providers
General Health Home Brochure
Behavioral Health Health Home Brochure
Diabetic Health Home Brochure
More information can be found by clicking on the links below:
WVU Diabetes Health Homes Program Evaluation
Centers for Medicare and Medicaid Services (CMS) Health Homes Information and Resources
Health Homes General Information
Behavioral Health Health Home Rates
Diabetes Health Home Rates
State Plan Amendments
Initial Health Homes State Plan Amendment (approved 1/27/15)
Behavioral Health Health Home Expansion State Plan Amendment (approved 5/4/17)
Diabetes Health Homes State Plan Amendment (approved 5/4/17)
KEPRO (Formerly APS Healthcare)