New Jersey Health Homes

Program Location: 
Hackensack, NJ
Payer Type: 
Medicaid
Payers: 
Medicaid
Description: 

CMS approved New Jersey's Health Home state plan amendment in March of 2015. In a partnership with the Division of Medical Assistance and Health Services (Medicaid) and the Department of Children and Families, DMHAS launched health homes in select counties in July of 2014.  The BHH is a high intensity service targeting those with the most need.

New Jersey has two Health Homes, an SMI adult Health Home and a children's SED Health Home:

In accordance with guidance from the Centers for Medicare and Medicaid Services (CMS), a Health Home must have the capability to provide all of the following services, as warranted based on members' needs:

  • Comprehensive care management;
  • Care coordination;
  • Health promotion;
  • Comprehensive transitional care (including appropriate follow-up from inpatient to other settings)
  • Individual and family support;
  • Referral to community and social support services;
  • Use of health information to link services as feasible and appropriate.

It is expected that the use of a behavioral health home model will result in improved health outcomes for the consumer base, better quality of treatment, and improved cost effectiveness; improved consumer experience with care; and declines in the use of hospitals, emergency departments, and other costly inpatient care. Currently, health homes are available in Bergen County.  Mercer County has a plan in place to begin health home services imminently.  DMHAS plans to expand services to Atlantic, Cape May, and Monmouth Counties beginning January 1, 2016.

Payment Model: 

New Jersey will receive a 90% enhanced FMAP (Federal Medical Assistance Percentage) for the specific health home services in Section 2703. The enhanced match does not apply to the underlying Medicaid services also provided to individuals enrolled in a health home. 
 
The 90% enhanced match is good for the first eight quarters in which the program is effective. New Jersey may receive more than one period of enhanced match, understanding that they will only be allowed to claim the enhanced match for a total of 8 quarters for one beneficiary. 

Last updated January 2019
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