Ohio Health Homes Program

Program Location: 
Columbus, OH
Payer Type: 
Medicaid
Payers: 
Medicaid

Reported Outcomes

Description: 

On September 17, 2012, the Centers for Medicare & Medicaid Services (CMS) approved a Section 2703 Health Home State Plan Amendment for Medicaid enrollees with serious mental illness or a mental health condition. Ohio Health Homes serve patients through Community Behavioral Health Centers (CPBHC). Initially, the program was implemented in five southern Ohio counties (Butler, Adams, Scioto, Lawrence, and Lucas) but expanded coverage statewide in 2013. 

CPBHCs employ licensed professionals who coordinate and help patients get access to necessary medical, mental health and alcohol and drug treatment, and social services. Community Behavioral Health Centers are expected to have established co-located or fully integrated primary and behavioral health services and manage data using an electronic health record (EHR). 

Payment Model: 

Participating practices will receive a monthly case rate. Rates will vary by health home based on caseload and dedicated health home staffing costs for each qualifying enrollee. 

Fewer ED / Hospital Visits: 

Comprehensive Evaluation Report (April 2015)

  • Overall, Health Homes’ utilization data did not show a reduction in ED or inpatient utilization for the period reviewed.
  • The Health Homes had high ED utilization rates; however, the Health Homes inpatient admission rates were generally low.
  • The utilization analysis did not show a significant effect of the Health Homes on ED or inpatient (non-mental health) utilization for most Health Homes or at the statewide level.
  • There was a small significant increase in mental health inpatient utilization rates among Health Home members relative to the comparison group. 
Improved Health: 

Comprehensive Evaluation Report (April 2015)

  • All health homes demonstrated increased proficiency and progress towards the integration of physical and behavioral health care. 
Improved Patient/Clinician Satisfaction: 

Comprehensive Evaluation Report (April 2015)

  • Positive scores for the Health Home sample were higher than the statewide sample for all domains
  • General Satisfaction was the highest rated subscale at 90 percent followed by Quality/Appropriateness and Participation in Treatment at 86 percent
  • Access was rated at 85 percent
  • The high rate of general satisfaction is congruent with the input from Health Homes regarding their low rate of consumers who have opted-out of the Health Homes. 
Cost Savings: 

Comprehensive Evaluation Report (April 2015)

  • Overall, Health Homes did not now show an overall cost savings.
  • All 5 of the evaluated Health Homes incurred statistically significant negative cost savings.
  • The magnitude of the negative cost savings ranged from $322 to $561 PMPM, with an overall statewide negative cost savings of $516 PMPM.
  • The primary driver of the cost increases, ignoring average monthly Health Home case rates, was found in pharmacy costs.
  • Members in all five Health Homes had significantly higher pharmaceutical costs than the comparison group, ranging in effect size from $48 PMPM for Butler to $140 PMPM for Unison
Last updated December 2015
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