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Integrated Health Home Demographics Brief, July 2013 - June 2017

Under Section 2703 of the Patient Protection and Affordable Care Act (ACA) of 2010, states were given the option to submit a State Plan Amendment (SPA) for the establishment of ‘health homes’ targeting Medicaid enrollees with chronic health conditions. As defined by the Centers for Medicare and Medicaid (CMS), the health home model provides care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. 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 (Magellan), a private health management company managed the Iowa Plan for Behavioral Health (Iowa Plan) from 1995 through 2015. The original SPA was granted to begin on July, 2013 with Magellan as the lead entity. Upon the privatization of Medicaid on April 1, 2016, amendments to the SPA were requested and were granted by CMS on July 13, 2016. These amendments changed the role of the previous lead entity (Magellan) to reflect the activities of the Managed Care Organizations (MCOs). The purpose of an IHH is to provide whole-person, patient-centered, coordinated care for adults with a serious mental illness (SMI) and children with a serious emotional disturbance (SED). The IHH represents an adaptation of the evidence-based practices of the health home model to incorporate a focus on behavioral care for individuals with serious psychological conditions.

Enrollment in an IHH is intended to mitigate some barriers to care among this population—namely, the challenges involved with navigating fragmented systems of care which often lack adequate coordination between behavioral and primary care medical services. Many primary care providers may lack the specialized training needed to help patients manage a mental health diagnosis, while behavioral health providers are limited in the scope of primary care services they can provide to patients. The IHH initiative attempts to create a singular point-of-access for individuals with a mental health diagnosis to obtain coordinated, comprehensive healthcare services across a spectrum of needs and conditions.

To be credentialed as an IHH, providers must meet criteria related to behavioral health accreditation and establish the team of healthcare professionals needed to provide comprehensive care coordination. IHH care is provided by community-based health homes across the state. IHH health homes were originally contracted with Magellan (these contract arrangements ended when Magellan left the state on December 31, 2015). Currently, IHH health homes are credentialed through the Managed Care Organizations (MCOs) and the state Medicaid program and provide statewide coverage for IHH services.

Momany, E. & Damiano, P. Integrated Health Home Demographics Brief, July 2013 - June 2017. Iowa City, IA:University of Iowa Public Policy Center.