Federal Health Home Requirements

Section 2703 of the federal Patient Protection and Affordable Care Act (ACA) establishes authority for states to develop and receive federal reimbursement for a set of health home services for their state's Medicaid populations with chronic illness. Health home services support the provision of coordinated, comprehensive medical and behavioral health care to patients with chronic conditions through care coordination and integration that assures access to appropriate services, improves health outcomes, reduces preventable hospitalizations and emergency room visits, promotes use of health information technology (HIT), and avoids unnecessary care.

Health Home services include:

  • comprehensive care management,
  • health promotion; transitional care including appropriate follow-up from inpatient to other settings,
  • patient and family support,
  • referral to community and social support services,
  • use of health information technology to link services.

Medicaid eligible individuals must have: (1) two chronic conditions; (2) one chronic condition and are at risk for a second chronic condition; or (3) one serious persistent mental health condition to qualify for health home services.