Archived Questions and Answers

General

Table of Contents

  1. How will DOH adjust members´ acuity scores based on members´ evolving needs?
  2. Will there be any particular identification or process established for linking persons who were previously High Cost as they transition from jail/prison and how will risk issues be assessed and incorporated into prioritizing access to services?
  3. Do the Health Home eligibility lists provided include the language the client speaks?
  4. Is there any funding available for Health Home implementation costs?
  5. Will the lead Health Homes ever have to go through a process of re–applying/recertifying/etc.?

Back to current Q&As

1. How will DOH adjust members´ acuity scores based on members´ evolving needs?

Acuity scores will be adjusted periodically based on claims and encounter data. Health Homes can access the member´s acuity score through the Health Home Member Tracking System and should be sharing this information with network care management partners. The Department will monitor changes in acuity on an ongoing basis. Determining the care management needs of a member is the responsibility of the care manager working together with the interdisciplinary Health Home team.

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2. Will there be any particular identification or process established for linking persons who were previously High Cost as they transition from jail/prison and how will risk issues be assessed and incorporated into prioritizing access to services?

A workgroup has been formed to examine best practices for linking individuals to Health Homes from the criminal justice system. More information can be found here under Health Home and Managed Care Organization Workgroup. We expect that Health Homes will partner with the corrections systems in their communities to establish smooth transitions.

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3. Do the Health Home eligibility lists provided include the language the client speaks?

The Medicaid tracking system does not have information on the language the member speaks. Health Homes need to work with their partners (who may have a relationship with the member) to help answer some of these questions. Usually it won´t be until the care manager is able to locate the member that their language may be identified.

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4. Is there any funding available for Health Home implementation costs?

Over 15 million dollars in Implementations Grants were awarded to Health Homes. More information is available by clicking here.

The State has received federal approval for an enhanced 1115 waiver to provide additional funds for Health Home Development; details on the process for distribution of these funds will be released in the Fall of 2014.

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5. Will the lead Health Homes ever have to go through a process of re–applying/recertifying/etc.?

After the initial three year period of designation, the State Implementation partners (DOH, OMH, AI, and OASAS) will collaboratively review each Health Home´s performance to determine if the Health Home will be redesignated. State redesignation of Health Homes will be determined based on the needs of the State, compliance with Federal and State program requirements designed to meet Health Home goals of decreased inappropriate inpatient admissions and emergency department visits and improved health outcomes of members. Performance on program benchmarks and quality metrics will be considered, effective engagement and retention rates as well as member satisfaction of enrolled Health Home members.

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