VBP Strategy Initatives:
- Health Homes Information for members with Chronic Conditions (Stage A)
- Behavioral Health Homes (Stage B)
- MaineCare Accountable Communities Initiative
- State Innovation Models Initiative
Stage A Health Home Year One Report:
The Department is pleased to release its "MaineCare Stage A Health Homes Year 1 Report: Implementation Findings and Baseline Analysis." The Department created and launched the first stage of its Health Homes initiative for members with chronic conditions in January 2013. Health Homes are a foundational component of the Department's Value-Based Purchasing Strategy and Maine's State Innovation Model (SIM) grant.
Building off the Maine multi-payer Patient Centered Medical Home model, the Department provides monthly reimbursement to primary care practices to support MaineCare members with chronic conditions through outreach, preventive health, care coordination, patient and family engagement. The Initiative also enables Community Care Teams across the state to partner with these Health Home practices to provide intensive care management and community supports to the highest need patients at the practices.
The Department commissioned the Muskie School of Public Service at the University of Southern Maine to produce this report.
MaineCare Health Homes Initiative: Re-opening of Practice Application for Participation
In order to support partnerships between primary care practices and community mental health agencies interested in participating in the Behavioral Health Homes initiative, MaineCare is re-opening its application for primary care practices that are not currently participating in Stage A Health Homes for MaineCare members with chronic conditions.
Practices interested in participating in Stage B Behavioral Health Homes (for individuals with serious mental illness or serious emotional disturbance) are encouraged to apply. Practices that apply and qualify will be eligible to participate in both Stage A and Stage B Health Homes initiatives as of April 1, 2014. Practices that are already participating in Stage A Health Homes do no need to apply to participate in Stage B Behavioral Health Homes. MaineCare will be following up separately with the existing Stage A practices to confirm participation in Stage B Behavioral Health Homes.
MaineCare currently has 159 Health Home practice sites across the state that, in partnership with Community Care Teams, deliver Health Home services to MaineCare members with chronic conditions through Stage A. Stage B of MaineCare's Health Home initiative, being implemented in April 2014, requires partnerships between a primary care Health Home practice and one or more licensed community mental health providers (the Behavioral Health Home Organization or BHHO) to manage the physical and behavioral health needs of individuals with significant mental health needs. Through this application, practices may participate in both Stage A and Stage B of the Health Home initiative beginning in April 2014.
In order to participate, practices must:
- Be participating MaineCare Providers;
- Have received National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PPC-PCMH) Recognition within one (1) year from the date of enrollment;
- Be located in the state of Maine;
- Have a fully implemented Electronic Health Record (EHR);
- Have or anticipate having an Memorandum Of Understanding/Memorandum Of Agreement (MOU/MOA) with at least one BHHO in its area;
- Comply with MaineCare Benefits Manual, Ch. VI, Section 1-Primary Care Case Management, Section 1.08-5-Twenty-Four Hour Coverage;
- Participate in Maine's multi-payer Patient Centered Medical Home (PCMH) Health Homes Learning Collaborative;
- Within one year of the BHHO's participation, must fully implement Maine's multi-payer Patient Centered Medical Home/ Health Homes Core Expectations.
Completed applications are due by Friday, January 24, 2014. For practices with more than one location, a separate application must be completed for each location. Updated Due Date
To access the online application, please click here or go to: https://www.surveymonkey.com/s/BehavioralHealthHomesPracticeApp
Additional information about the Health Home and Behavioral Health Home initiatives can be found at MaineCare's Value-Based Purchasing Website: http://www.maine.gov/dhhs/oms/vbp/index.html
To review the current MaineCare regulation on Health Homes, please go to: http://www.maine.gov/sos/cec/rules/10/144/ch101/c2s091.doc
The Department of Health and Human Services has posted Requests for Applications (RFAs) for two initiatives under its Value-Based Purchasing Strategy, Accountable Communities and Behavioral Health Homes.
Behavioral Health Homes RFA (posted 10/11/13): http://www.maine.gov/dhhs/oms/vbp/health-homes/stageb.html
Accountable Communities RFA (posted 10/10/13):http://www.maine.gov/dhhs/oms/vbp/accountable.html
September 2013 Public Forums
Discussions during the 3 regional forums throughout the state consisted of the following:
- Behavioral Health Homes Overview
- State Innovation Model (SIM) Grant Context and Impact on VBP Initiatives
- Accountable Communities Overview and Request for Applications
- VBP Forum Presentation Portland 09/26/2013 PowerPoint
- VBP Recording from the Augusta 09/16/2013 Webinar
NCQA Recognition Due December 31, 2013
Health Home practices must achieve Patient Centered Medical Home (PCMH) recognition by the National Committee for Quality Assurance (NCQA) no later than December 31, 2013.
Questions? Email James Leonard for questions about the project, upcoming events, and meetings.
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