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Under Construction: One States Approach to Creating Health Homes for Individuals with Serious Mental Illness

机译:正在建设中:一州为严重精神疾病患者建立健康之家的方法

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摘要

Changes to the health care market associated with the Patient Protection and Affordable Care Act (ACA) are creating both need and opportunity for states, health plans, and providers to improve quality, outcomes, and satisfaction through better integration of traditionally separate health care delivery systems. Applications of the term “integrated care” vary widely and include, but are not limited to, the integration of care for Medicare-Medicaid dually enrolled beneficiaries, the integration of mental health and substance abuse (also known as behavioral health), and the integration of mental health and substance abuse with medical care, most commonly primary care. In this article, integrated care refers to well-coordinated physical health and behavioral health care. Medicaid Health Homes are emerging as a promising practice, with sixteen states having adopted the Health Home model through approved State Plan Amendments. This article describes one state's journey towards establishing Health Homes with a behavioral health focus. We discuss a partnership model between the relevant state organizations, the contracted providers, and the behavioral health managed care organization responsible for many of the supportive administrative functions. We highlight successes and operational challenges and offer recommendations for future Health Home development efforts.
机译:与《患者保护和负担得起的医疗法案》(ACA)相关的医疗保健市场的变化,正在为州,医疗保健计划和提供者通过更好地整合传统上独立的医疗保健提供系统而提高质量,结果和满意度的需求和机会。 “综合护理”一词的应用范围很广,包括但不限于医疗保险-医疗补助双重注册受益人的综合护理,精神健康和药物滥用(也称为行为健康)的整合以及心理保健和药物滥用,最常见的是初级保健。在本文中,综合护理是指协调良好的身体健康和行为健康。医疗补助保健之家正在成为一种有前途的做法,已有十六个州通过批准的《州计划修正案》采用了保健之家模式。本文介绍了一个州建立以行为健康为重点的健康之家的过程。我们讨论了相关国家组织,合同提供者和负责许多支持性行政职能的行为健康管理医疗组织之间的伙伴关系模型。我们重点介绍成功案例和运营挑战,并为未来的健康之家开发工作提供建议。

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