Health Homes, Affordable Care Act
In January 2013, Maine established Health Homes under federal authority pursuant to Section 2703 of the Aff ordable Care Act to improve care coordination for MaineCare members with chronic conditions. Stage A of the Health Homes initiative focuses on members with complex medical chronic conditions. Stage B, planned for early 2014, will focus on persons with severe and persistent mental health conditions and children with serious emotional disturbances. The Stage A demonstration builds off the State’s existing Maine multi-payer Patient Centered Medical Home (PCMH) Pilot project and Maine’s Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing add-on payments to primary care practices and strengthening the community care team (CCT) model to provide care management and social support services to high-need MaineCare patients.
As part of the initiative, MaineCare commissioned the Muskie School of Public Service to evaluate this new model of care. Th is report presents evaluation fi ndings after the fi rst year of Stage A implementation and provides preliminary baseline data on quality, use and cost of care for eligible MaineCare members in Health Homes (HH) relative to a comparison group that will form the basis for assessing overall impact at the close of the two years of enhanced federal match under the initiative.
Th e report is divided into two parts. Part I focuses on how the model has been implemented in Year 1 including the number of practices and members that are participating and how practices and Community Care Teams (CCTs) have enhanced service delivery based on program data and qualitative interviews with participating practices, CCTs and stakeholders. Part II presents baseline data from 2011, prior to the beginning of the Stage A, comparing the quality, utilization and cost of services for MaineCare members that are participating in Health Homes with members with similar HH eligible conditions that did not enroll in Health Homes. Preliminary baseline data included in this report will be updated and used in the fi nal report to assess how quality, use and cost of MaineCare services changed over time in each of these groups, to evaluate the impact of the intervention.
Funding Organization or Grant
Th is report is supported through the MaineCare Informatics and Evaluation Cooperative Agreement between the Maine Department of Health and Human Services and the University of Southern Maine (CA-MC-13-227).
Fox K, Gray C, Rosingana K. Early Lessons Learned in Implementing MaineCare Health Homes. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.