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, was selected to evaluate the program. The evaluation efforts were supported by the generous contribution of The California Endowment.
This second HHP Interim Evaluation report updates enrollment patterns, demographics, and services HHP enrollees received, reported in the first interim evaluation report. This report also categorizes HHP enrollees based on their utilization of acute care services prior to HHP enrollment and describes service utilization before and during HHP by these acute care utilization categories. Additionally, this report includes analyses of 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. Findings indicated some improvements in metrics that reflected processes and outcomes of care compared to the control group but no change in others. In particular, UCLA found greater declines from before HHP in core metrics for ED visits and hospitalizations compared to the control group. A future report will assess the health outcomes, utilization, and estimated payments of HHP enrollees by the end of the program.
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