Medicaid Health Homes: Emerging Models and Implications


Federal Policy Brief | November 9, 2012

Files: Medicaid Health Homes: Emerging Models and Implications for Solutions to Chronic Homelessness (PDF | 406 KB | 5 pages)

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Medicaid Health Homes

Emerging Models and Implications for Solutions to Chronic Homelessness

Several states have begun implementing the new Medicaid health home benefit created by the Affordable Care Act of 2010 (ACA). As discussed below, this new benefit is a source of funding for care coordination activities that are frequently not covered in Medicaid programs. A health home can help improve behavioral and physical outcomes for vulnerable homeless people, which in turn are proven to reinforce positive housing outcomes. Medicaid payments for health homes can also increase safety net capacity for health care and housing at the community level.

Implementation is in early stages and the impact of this new ACA program in the homeless assistance arena is not yet known. However, advocates for vulnerable people experiencing homelessness have a valuable perspective and can be a constructive voice as home health benefits are created and implemented across the states. As this Alliance policy brief shows, the emerging state models point the way for homeless advocates to engage with Medicaid leaders about integrating supportive housing and health care services. For homeless assistance, key policy considerations include:

  • Methods for targeting behavioral health populations;
  • Criteria defining the provider types that can be designated a health home;
  • Payment strategies to support the intensity of services needed to stabilize people in housing; and
  • Enrollment practices that recognize the needs of vulnerable homeless people.

The policy brief offers background on Medicaid health homes, and reviews models that have already been approved by the Centers for Medicare and Medicaid Services (CMS) within the U.S Department of Health and Human Services (HHS). This information can prepare advocates and homeless assistance providers to participate in strategy discussions about integrating health care and supportive housing – in their communities or on a statewide basis.