Enrolling as an Iowa Medicaid Provider in the Health Home Program

What is a Health Home?

Background

Health Home is a Medicaid program that began in July of 2012 to meet the needs of Medicaid Members. The goal was to target members with chronic conditions, engage them in their health, coordinate their care and show improvement in the health of this population.

Providers must meet standards outlined by the State and seek patient centered medical home (PCMH) Recognition or Accreditation within 12 months of enrolling in the program. To facilitate a team-based, community focused approach, providers participating as a Health Home must connect to the Iowa Health Information Network (IHIN).

“The Health Home model is an opportunity for Iowa Medicaid to transform the delivery of care to vulnerable individuals with very challenging health issues from a fragmented system to an integrated, person-centered system that can better address their health, social and environmental needs in one coordinated delivery of care.” Jennifer Vermeer

Iowa Medicaid’s Health Home program is based on the foundation that primary care is delivered in a patient-centered medical home (PCMH) model.  

Where are Health Homes currently operating in Iowa?

What is a Medical Home?

Iowa Medicaid’s Health Home program is based on the foundation that primary care is delivered in a patient-centered medical home (PCMH) model. 

According to the Patient-Centered Primary Care Collaborative (PCPCC), the medical home is:

“A model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. It has become a widely accepted model for how primary care should be organized and delivered throughout the health care system, and is a philosophy of health care delivery that encourages providers and care teams to meet patients where they are, from the most simple to the most complex conditions. It is a place where patients are treated with respect, dignity, and compassion, and enable strong and trusting relationships with providers and staff. Above all, the medical home is not a final destination instead, it is a model for achieving primary care excellence so that care is received in the right place, at the right time, and in the manner that best suits a patient's needs.”

 

Adapted from the AHRQ definition, the PCPCC describes the medical home as an approach to the delivery of primary care that is:

  • Patient-centered: A partnership among practitioners, patients, and their families ensures that decisions respect patients’ wants, needs, and preferences, and that patients have the education and support they need to make decisions and participate in their own care.
  • Comprehensive: A team of care providers is wholly accountable for a patient’s physical and mental health care needs, including prevention and wellness, acute care, and chronic care.
  • Coordinated: Care is organized across all elements of the broader health care system, including specialty care, hospitals, home health care, community services and supports.
  • Accessible: Patients are able to access services with shorter waiting times, "after hours" care, 24/7 electronic or telephone access and strong communication through health IT innovations.
  • Committed to quality and safety: Clinicians and staff enhance quality improvement through the use of health IT and other tools to ensure that patients and families make informed decisions about their health.

Health Home Happenings Newsletter

Helpful information and tips for success for Iowa's Health Homes

July 2014 Edition

Why Enroll as a Health Home Provider?

Benefits for Providers

  • Providers can practice more proactive, coordinated care that they want to provide, because of a new reimbursement structure.
  • More opportunities to track, coach and engage the patient’s.
  • Improved communication and coordination for better patient outcomes
  • Improved utilization of health information technology

Benefits for Patients

  • Better coordination and management of their often complicated and complex care.
  • Help navigating multiple systems
  • More engagement in their own care
  • Access to a wider range of services 

Provider Potential Income with the Quality Performace Bonus

Health Home Brochure 

Health Home Program Executive Summary

Who is Eligible?

There are requirements to be met, called Health Home Standards, to be able to participate in the Health Home Program. Minimum requirements listed below:

  • Use some form of a Patient Registry
  • Electronic Health Record (EHR)
  • Agree to participate in the Iowa Health Information Network
  • Dedicated care coordinators
  • Expanded hours for access
  • Alternative means to communicate with patients and get them engaged, such as email, personal health records, reminders, etc.
  • On the path to PCMH recognition or certification

How to Enroll as a Health Home

We are excited to have you as part of our Health Home Program. A potential participation call is available for clinics that are interested. Contact Pamela Lester at plester@dhs.state.ia.us or call 515-256-4655. To enroll complete the forms below and email them to plester@dhs.state.ia.us. Once the forms are processed there will be a call with your team to assist with the success of the program.

Health Home Tools: Getting Started

Guide for Health Home Services

Patient Tier Assessment Tool (PTAT)

Iowa Medicaid Portal Access (IMPA)

Quality Measures Thresholds