Summary
Summary: The California Department of Health Care Services (DHCS) implemented the Medi-Cal Health Homes Program (HHP) to serve eligible Medi-Cal Managed Care Health Plan (MCP) members with complex needs, including individuals with chronic conditions and high levels of service utilization. HHP was authorized under California Assembly Bill 361 and approved by the Centers for Medicare and Medicaid Services under Section 2703 of the 2010 Patient Protection and Affordable Care Act. HHP was operated in 12 California counties by 16 MCPs that contract with Community-Based Care Management Entities (CB-CMEs). A UCLA Center for Health Policy Research team, led by Center Associate Director Nadereh Pourat, PhD, was selected to evaluate the program. The evaluation efforts were supported by the generous contribution of The California Endowment.
This final HHP Evaluation report updates enrollment patterns, demographics, services received, and changes in HHP core metrics, utilization measures, and estimated Medi-Cal payments compared to a similar group of Medi-Cal beneficiaries not enrolled in HHP reported in the first interim and/or second interim evaluation reports. Findings indicated that by the end of HHP in December 2021, 90,045 individuals had enrolled in the program. Some improvements in HHP core metrics were found that reflected improved processes and outcomes of care compared to the control group but no change in others. Among measures of service utilization, UCLA found greater declines from before HHP compared to the control group in all service types, including ED visits and hospitalizations, expect for long-term care stays. Furthermore, HHP enrollees showed a greater declining rate in estimated Medi-Cal payments compared to controls after HHP enrollment. The reduction in services and associated payment was likely due to more intensive assessment of patients for medical, behavioral, and social needs and redirecting patients to needed services.
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