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Child-Centered Health Homes in California

[The following post was written by Alison Klurfeld, ITUP’s Summer Policy Associate]

A webinar today from Ch1ldren Now discussed how California can support and implement patient-centered medical homes (PCMHs) for children.  Although physician groups, academics, and advocates support PCMHs for all kinds of patients, the concept was originally developed in pediatric care.

Leah Newkirk, Director of Health Policy at the California Academy of Family Physicians, characterized the triple aim of a PCMH as facilitating population health, improving care quality, and decreasing costs.  She emphasized that a PCMH is not just a place, but a different way of delivering care and can particularly benefit children through prevention and improved management of chronic conditions.

California already has several medical home initiatives. For example, SB393 (Hernandez), which would encourage licensed health care providers and patients to partner in a patient-centered medical home, has been passed by the Senate and is currently being reviewed by the Assembly Health Committee.  Brian Hansen, Health Reform Advisor at DHCS, spoke about another initiative – California’s efforts to implement Section 2703 of the ACA, which provides a 2-year enhanced FMAP (90%) for medical home care coordination for Medicaid patients.  In order to be eligible, patients must have 2 chronic conditions, have 1 chronic condition and be at risk of another, or have a serious chronic mental illness.  The state can limit the program to specific conditions, by acuity, or by geography.  CMS guidance on Section 2703 is here.

DHCS has received $ 1 million in planning grant funds from CMS with a match from the California Endowment and has subcontracting with HMA for 4-month assessment of different health home program options.  Specifically, the assessment will focus on how expensive it would be for the state to provide its share of new funding (10% state share for coordination, 50% for direct medical expenses).  The goal is to use only 1/3 of planning funds for the assessment so that the other 2/3 can go toward pre-implementation planning for the health home program the state selects.  Questions can be emailed to ACAhealthhomeoption@dhcs.ca.gov.

Last, Dr. Thomas Klitzner spoke about the pediatric medical home at UCLA Mattel’s Children’s Hospital.  The program serves CCS children with 2 or more chronic conditions through primary care management with Care coordination by bilingual family liaisons.  The program reduced ER use by 55% and eliminated disparities in satisfaction between English and Spanish speakers.

You can track Medical Home Initiatives in California here.