Washington’s Health Home program is a standout

Health Homes are programs that provide additional medical assistance and care coordination for individuals with at least one chronic condition and are at risk for a second. Outlined in the Affordable Care Act, a Health Home refers to a provider who works in coordination with other health care professionals to provide specific services to these high-risk and high-cost patients. These services might include one-on-one care management, transitional and follow-up care, and referrals to community and social support services.

Across the United States, twenty one states have formed 32 different Health Home models, and among those models, Washington’s is a standout.

Washington State launched its Health Home project with CMS in 2013 as a demonstration to provide coordinated care for dual-eligible enrollees. The program was tasked with finding innovative ways to improve patient care while also cutting costs. Through individualized care and interaction, Washington’s Health Home program has been able to save money by reducing preventable hospital re-admissions, emergency rooms visits, and reducing duplication of services.

“Connecting these individuals with state and community resources that assist with their needs and remove obstacles to health management can greatly improve their well-being while avoiding expensive treatments for preventable consequences of unmanaged conditions,” says David Kelly, Executive Director of the Area Agency on Aging & Disabilities of Southwest Washington (AAADSW).

A study from CMS shows that in its first year (2013-2014), the Washington Health Home program generated $34,891,668 in Medicare savings. In its second year, preliminary results are showing that the program produced $32,091,003 in savings. Up to 50 percent of these savings can be shared with the state, depending on a finalized cost impact and performance analysis, but so far, Washington’s Health Care Authority has received approximately $20 million in performance payments from CMS.

Kelly says the two year savings of $67 million are significant, especially compared to other similar programs in the US.

“This is quite remarkable as Washington State is the only state in the nation to have achieved a verified cost savings among the various nationwide Innovations/Health Home projects initiated three years ago,” says Kelly.

Kelly also says that while the amount of money saved is astounding, the improved health outcomes of Health Home beneficiaries are even more rewarding. Kelly’s care coordination organization, AAADSW has seen a tremendous amount of success within the Health Home system in Washington. AAADSW has program engagement rates 10 times the national average and their patients show improved scores on a variety of health cost and health management measurements.  In a focus group of individuals who use Health Home services, DSHS found more than half of participants reported significant improvement in their health and quality of life, and many said their health home care coordinator helped them plan and achieve their health goals.

The Heath Home program is expanding in Washington. Originally set to expire in 2016, the project has been extended to 2018 and the state is requesting an additional extension through 2020. Starting in 2017, Washington’s Health Home coordination services expanded to include King and Snohomish counties. With the addition of these counties, Health Home is officially available in all 39 Washington counties.