A new report from the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS), Financing and Policy Considerations for Medicaid Health Homes for Individuals with Behavioral Health Conditions: A Discussion of Selected States’ Approaches, reviews the policy considerations and options for states and providers to establish reimbursement methodologies and payment rates for health homes.

The Centers for Medicare and Medicaid Services (CMS) has approved Medicaid coverage of health homes in twelve states, six of which include mental and substance use disorders as eligible chronic conditions. Learn how these states structured their health homes, especially Missouri and Rhode Island, which were the first states to receive federal approval for health home services coverage.

Designed specifically for use by community-based primary care and behavioral health providers, the report includes both a general overview of most aspects of health home service design and a detailed description of specific policy areas (e.g., use of CMS core quality measures and available reimbursement options). It also discusses the roles of quality measurement and health information technology (HIT) in a health home.

The report conveys what processes state governments may need to employ with the Substance Abuse and Mental Health Services Administration (SAMHSA) and CMS to receive consultation and approval for Medicaid health home services.

Download the report

Financing and Policy Considerations for Medicaid Health Homes for Individuals with Behavioral Health Conditions is the latest in a series of resources from CIHS that explore establishing health homes for people with mental and substance use disorders. These resources provide a comprehensive review of the information providers and states need to anticipate when establishing, or considering, a health home model.

An earlier document, Behavioral Health Homes for People with Mental Health & Substance Use Conditions: The Core Clinical Features, shares evidence on how best to structure a health home for people with behavioral health conditions.

For more information on health homes, visit the CIHS web page on health homes.