Evaluation of Iowa's Integrated Health Homes for Individuals with Serious Mental Illness

Under Section 2703 of the Patient Protection and Affordable Care Act (ACA) of 2010, Iowa was granted an Amendment to their State Plan (SPA) for the establishment of ‘health homes’ targeting Medicaid enrollees with chronic health conditions. The Iowa Integrated Health Home (IHH) initiative was launched on July 1, 2013 as a partnership between the Iowa Department of Human Services (DHS) and Magellan Behavioral Care of Iowa (http://dhs.iowa.gov/ime/providers/integrated-home-health).

The Integrated Health Home (IHH) is specific to adult members with severe mental illness (SMI) and child members with serious emotional disturbances (SED). The IHH provides incentives for community mental health centers to integrate the care of people with serious and persistent mental disorders with a primary care physician. This integration of services is intended to reduce the effects of medical disorders and diseases through better coordinated behavioral and physical health services, thereby reducing potentially preventable hospitalizations and emergency room visits for this population. The IHH program began on July 1, 2013.

Through the IHH initiative, care is provided by community-based health homes across the state and overseen by Magellan. To be credentialed as an IHH, providers must meet criteria related to behavioral health accreditation and demonstrate the ability to establish the team of healthcare professionals needed to provide comprehensive care coordination.

The PPC evaluation of this program consists of four parts: 1) evaluation of member experiences through consumer surveys, 2) a comparison of the outcomes of care for IHH enrollees, 3) a comparison of the costs of care for IHH enrollees and 4) qualitative interviews with IHH Directors and key staff.  The first consumer survey was conducted during the period of October 2014 – December 2014. Outcomes of care and cost comparisons have been analyzed from the enrollment, claims, and encounter data provided by the IDHS and Magellan Health for the first year of the program, July 2012-June 2013.