PDF Version
More than 250,000 Medicaid recipients with chronic health conditions will soon have access to enhanced care coordination and other services to improve their overall health when the Alabama Medicaid Agency expands its Health Home program on April 1, 2015.
Six probationary Regional Care Organizations (RCOs) have signed contracts to operate Health Home programs. The groups include: Region A: Alabama Community Care – Region A and My Care Alabama; Region B: Alabama Care Plan; Region C: Alabama Community Care – Region C; Region D: Care Network of Alabama; and Region E: Gulf Coast Regional Care Organization. Click here to see a regional map.
The program, which has operated since 2012 as Patient Care Networks in 21 counties of the state, is expanding statewide as an interim step toward implementation of full-risk Regional Care Organization. RCOs are locally-led managed care systems that will ultimately provide healthcare services to Medicaid enrollees at an established cost under the supervision and approval of the Alabama Medicaid Agency.
In contrast, the Health Home program is defined by the federal government as an optional Medicaid program that integrates and coordinates care for patients with certain chronic conditions to achieve improved health outcomes. In Alabama, the Health Home program is set up to add an additional level of support to Patient 1st Primary Medical Providers (PMPs) by intensively coordinating the care of patients who have or who are at risk of having certain chronic conditions: asthma, diabetes, cancer, COPD, HIV, mental health conditions, substance use disorders, transplants, sickle cell, BMI over 25, heart disease and hepatitis C.
Care management, or coordinated care, in the Health Home program is done by connecting patients with needed resources, teaching self-management skills, providing transitional care and bridging medical and behavioral services, among other efforts.
“This interim step is designed as a building block for probationary RCOs that are working toward full certification by facilitating network development and providing resources while offering the probationary RCOs an opportunity to demonstrate that they have resources to manage patients in their region,” said Dr. Robert Moon, Chief Medical Officer and Deputy Commissioner for Health Systems.