CHA News Article

DHCS Releases Concept Paper on ACA Medicaid Health Home State Plan Option
Requests stakeholder feedback by Dec. 1

The California Department of Health Care Services (DHCS) has released a concept paper for stakeholder comment on the Medicaid Health Home State Plan Option, authorized under Section 2703 of the Affordable Care Act. Section 2703 allows states to create Medicaid health homes to coordinate the full range of physical health, behavioral health, and community-based long-term services and supports (LTSS) required by Medicaid members with chronic conditions. Federal matching funds are available for two years at 90 percent. If the plan is implemented in California, The California Endowment has offered to fund the remaining 10 percent (up to $25 million per year) required for these additional services for the same two-year period. AB 361 (Chapter 642, Statutes of 2013) authorized California to submit a Section 2703 state plan amendment to the Centers for Medicare & Medicaid Services, subject to several conditions, including cost neutrality and an evaluation after the first two years.

The Health Homes for Patients with Complex Needs initiative is a key care improvement initiative outlined in the State Health Care Innovation Plan (Innovation Plan), which formed the basis of a three-year State Innovation Model testing grant application submitted to the Center for Medicare and Medicaid Innovation on July 18.

In the concept paper, DHCS has outlined its initial thinking on the following key components of the initiative: potential target populations, acuity, geographic phasing considerations, health home network infrastructure, general health home network qualifications, certification process, provider education and technical assistance, services definitions, health information exchange and technology requirements, quality measures and evaluation plan, payment methodology and rates, and the timeline. DHCS requests stakeholders submit comments and feedback to hhp@dhcs.ca.gov by Dec. 1.

 More information is available in the attached DHCS concept paper. For more information on the Health Homes for Patients with Complex Needs initiative, visit www.dhcs.ca.gov/provgovpart/Pages/HealthHomes.aspx. For more information on California’s State Health Care Innovation Plan visit www.chhs.ca.gov/pages/pritab.aspx.

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