The section authorizes health homes, a person-centered care delivery model focusing on improving outcomes for Medicaid beneficiaries with chronic conditions. The guidance comes in the form of a “recommended” core set of quality measures to assess the new care delivery model, but CMS intends to implement these measures in forthcoming rules.
The measures are not mandated until the rules are promulgated, but the guidance will aid states as they consider design and implementation of their health home programs, according to a letter to state Medicaid directors. “This advance notice will also give states time to share information with their health care providers, which is important, since health home providers will be required to report health quality measures in order to receive payment.”
The measures cover adult body mass index assessment, ambulatory care-sensitive condition admission, care transition records transmitted to health care professionals, follow-up after hospitalization for mental illness, an all-cause readmission plan, screening for clinical depression and a follow-up plan, alcohol and other drug dependency treatment, and controlling high blood pressure.