Session 16– May 7, 2013
Program Updates
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 Working on timing for next list release-new lists for
Phases 1 and 2 and first list for Phase 3.
 Still need designated Health Home for Southern Tier
counties.
 CMART - Ongoing technical assistance calls; first
submissions are due May 13, 2013 for 2012 FACT-GP data,
full submissions for first two quarters of 2013 are due
August 5, 2013
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 Ongoing refinements to Member Tracking System
 Health Home team will be using SurveyMonkey more
extensively to better implement the program and
take in feedback on various subjects
 Health Home and Managed Care Workgroup has been
reconvened, six subgroups identified to work on key
issues
3
 Next Learning Collaborative scheduled May 30 in NYC; agenda is being
developed.
 Center for Health Care Strategies (CHCS) has launched an online
community for New York Health Homes who are a part of the Learning
Collaborative funded by the New York State Health Foundation and
facilitated by CHCS.
 The online community will allow Health Homes to participate in online
conversations with other Health Homes. The goal is to provide a safe space
for Health Home staff in all phases to share best practices, resources and
ask questions about implementation.
 You are invited to join the community if you are a staff member of a health
home agency or network partner:
To join, please contact: Anjana Pandey, [email protected]
 Network partners and MCOs continue to develop
operational policies and procedures.
 Contracts are being executed.
 Governance models continue to evolve.
 Subcontracts and agreements continue to be formalized
with network partners.
 Active billing for Health Home services (Outreach and
Engagement and Active Care Management).
5
Statewide Health Home Enrollment Statistics (Based on Jan 2012 to April 2013 Claims)
Total Number Health Homes
50
Converting Members
# of HH Recipients Engaged in Outreach
608
New Members
# of HH Recipients Engaged in Outreach
10,102
Converting Members
# of HH Recipients Engaged in Active Care Management
21,962
New Members
# of HH Recipients Engaged in Active Care Management
6,749
Total # HH Recipients (Distinct count)
Total Health Home Eligible Individuals (MHSA and others)
34,022
805,000
# of Higher Risk Members
224,000
Higher risk members are identified based on predictive risk model and ambulatory connectivity measure; e.g.,those with
lower ambulatory connectivity and those more likely to die or have an inpatient or nursing home admission)
% of Higher Risk Members
% of Higher Risk Members Enrolled
28%
15.2%
6
Total HH Billings from January 2012 – February 2013 as of April 25, 2013
Claim Type
Amount Paid
Claim Count
Recipients
Amount Paid Per
Claim
Converting Legacy
Claims
$94,372,022
158,888
22,286
$594
New Health Home
Claims
$6,998,234
38,348
15,302
$182
$101,370,256
197,236
34,022
$514
Total
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Amount Paid
Members
8
Health Home Spending on Outreach vs.
Enrollment Services (Jan 2012 - July 2012)
46%
54%
Health Home Spending on Outreach vs. Enrollment
Services (Aug 2012-Feb 2013)
42%
58%
Enrollment (rate code 1386)
Outreach (rate code 1387)
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Questions?
Visit the Health Home website:
http://www.health.ny.gov/health_care/medicaid/program
/medicaid_health_homes/

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Get updates from the Health Homes listserv. To subscribe
send an email to: [email protected] (In
the body of the message, type SUBSCRIBE HHOMES-L
YourFirstName YourLastName)

Email questions or comments: [email protected]

Call the Health Home Provider Support Line: 518-473-5569
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