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Kansas Launches 'Health Home' Framework For Mentally Ill In Medicaid

State officials last week formally launched a “health home” initiative they hope will help Medicaid enrollees with mentally illnesses live healthier lives and lower the state’s health care costs. 

“We have several goals,” says Becky Ross, director of Medicaid initiatives at the Kansas Department of Health and Environment. “But the main goal, first and foremost, is to keep people out of the emergency room, reduce inpatient stays as much as possible and help people learn more about how to manage their chronic conditions, whatever those conditions might be.”

The initiative had been slated for a Jan. 1, 2014, rollout but was pushed back to Aug. 1 after Ross and other health care officials said they needed more time to ensure the program’s readiness. 

A similar initiative for Medicaid enrollees with chronic illnesses — diabetes and asthma, primarily — had been set to begin July 1, 2014, but was abruptly shelved after KDHE officials became concerned that not enough health care providers had agreed to participate. 

KDHE officials now say the health home initiative for the chronically ill is being re-evaluated and is not expected to be up and running until sometime after Jan. 1, 2015.

But the health home initiative for the seriously mentally ill is moving forward. KanCare contractors began receiving lists of would-be enrollees last month; actual service delivery began Aug. 1.

“Folks should already be getting phone calls from their home health partners, wanting to set up appointments to begin the process for setting up their health action plans,” Ross says.

Most enrollees, she says, have received inpatient psychiatric care in the past.

Medicaid claims data, Ross says, show that approximately 36,000 enrollees are eligible for assignment to a health home.

The enrollment process, she says, is “passive,” meaning that beneficiaries are assigned to a provider but are free to “opt out” at any time. Ross says that as of last week about 2,200 would-be enrollees had decided to opt out.

Each of the state’s 26 community mental health centers have agreed to become health homes. Several county health departments and many of the larger safety net clinics are participating as well.

As health homes, the providers assume responsibility for making sure their patients receive six services:

  • Comprehensive care management.
  • Individual and family supports.
  • Referral to social and community services.
  • Physical and mental health care coordination.
  • Comprehensive transitional care from institutional to community-based settings.
  • Health promotion.

Marilyn Cook, who runs COMCARE in Wichita, one of the largest community health centers in the state, says she welcomes the onset of health homes. 

“There’s some confusion about what a health home is,” she says. “People tend to think of it as a service, but it’s really not; more than anything else, it’s an attitude. The services have always been there in one form or another.

“What a health home does is put them all together,” she says. “It’s an approach; it’s an attitude.”

Dave Ranney is senior writer/editor with KHI News Service, an editorially independent reporting program of the Kansas Health Institute.

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