Health Homes

Health Homes, Behavioral Health Homes, and Opioid Health Homes

The three health home programs are an important component of Maine's Value-Based Purchasing strategy, a multi-pronged MaineCare initiative designed to improve the health care system, improve population health, and reduce cost. Health Home services include care coordination, case management, individual and family support, and health promotion/education. Each organization that is partnering to provide health home services receive a per member, per month (PMPM) payment.

Participation in any of the three health home programs is voluntary, and members can opt out of the service at any time.

Health Homes

Health Homes includes MaineCare members who have two chronic conditions or one chronic condition and are at risk for another. Health Homes are a partnership between an enhanced Health Home primary care practice and one of ten Community Care Teams (CCTs) around the state.

Health Homes, including provider requirements, are further described in the MaineCare Benefits Manual.

Participating Health Home and Community Care Team Provider Information

Materials and Forms

Health Home Member Informational Pamphlet (PDF)

Questions? 

Email the VBP Unit for questions about the project, upcoming events, and meetings.

Behavioral Health Homes

Behavioral Health Homes are a partnership between a licensed community mental health provider (the Behavioral Health Home Organization or BHHO) and one or more Health Home practices to manage the physical and behavioral health needs of eligible adults and children. Behavioral Health Homes build on the existing care coordination and behavioral health expertise of community mental health providers.

Behavioral Health Homes, including provider requirements, are further described in the MaineCare Benefits Manual.

Pay-for-Performance

In April 2018, a Pay-for-Performance (P4P) provision for Behavioral Health Home (BHH) providers was implemented, placing one percent of total BHH payments at risk pending performance on a quality measure.

The current quality measure is as follows: Of the MaineCare members assigned to the BHHO who had two or more fills of antipsychotic medication, the percentage of members who had at least one HbA1c or fasting blood glucose test. This measure was designed based upon the American Diabetes Association’s (ADA) recommendation: "Annually screen people who are prescribed atypical antipsychotic medications for prediabetes or diabetes." (Diabetes Care 2004 Feb; 27(2): 596-601. http://dx.doi.org/10.2337/diacare.27.2.596 / as amended 2010). The performance threshold for the quality measure has been set at 75%.

More information on the performance measure and P4P provisions can be found in the MaineCare Benefits Manual.

Participating Behavioral Health Home (BHH) Provider Information

Materials and Forms

HH/BHH Memorandum of Understanding Example (Word)

Questions? 

Email the BHH email box for questions about the project, upcoming events, and meetings.

Opioid Health Homes (OHH)

Opioid Health Homes (OHH) deliver integrated office-based Medication Assisted Treatment (MAT), opioid dependency counseling, and comprehensive care management for eligible MaineCare members and uninsured individuals with opioid use disorder.

The OHH model utilizes team-based care to support both the individual in treatment as well as the providers delivering care.

Opioid Health Homes, including provider requirements, are further described in the MaineCare Benefits Manual.

Accepting Applications

Opioid Health Homes (OHH) applications are now open. You can download and review a reference copy of the OHH Application (PDF) before completing the online application. To apply, please use our online OHH application to become an Opioid Health Home.

Participating Opioid Health Home (OHH) Provider Information

Questions? 

For questions pertaining to the Opioid Health Homes, please contact the Opioid Health Home email box.

Public Reporting

Goals for Public Reporting

  1. Improve accountability and quality of care
    Public reporting motivates organizations to improve and maintain high levels of performance and incentivizes providers to meet best practice recommendations.
  2. Improve patient decision-making through transparency
    Public reporting gives the public an opportunity to learn how the healthcare system works to deliver individual patient care. Maine residents will be able to identify the physician's office that will best meet their needs.
  3. Improve peer-to-peer comparisons
    Public reporting allows provider practices to compare their adherence to best practice recommendations to other providers around the state. Providers can identify their strengths and areas for improvement.