Overview
Health Home Care Coordination (HHCC) is a Medicaid benefit for individuals with higher-than-average health needs. This person-centered, community-based service helps individuals identify, access, and manage various health services, ensuring continuity of care for their physical, emotional, community, and developmental needs.
What is Health Home Care Coordination?
The HHCC program is a Medicaid benefit that specifically focuses on individuals with high health needs to support them in engaging with comprehensive health services and reducing potential gaps between providers.
A Care Coordinator will meet with an enrollee in the community or hospital setting to support them within 6 domains of service
- Comprehensive Care Management
- Care Coordination
- Health Promotion
- Comprehensive Transitional care and follow-up
- Individuals and Family Support
- Referrals for Community and Social Support.
Individuals who participate in the HHCC program have been shown to have stronger health outcomes and a significant reduction in Medicaid expenses.
How to Qualify for the HHCC Program
This is a Medicaid benefit for Dual enrolled individuals (Medicaid, Medicare who do not have Medicare Part C.)
There are 3 qualifiers that an individual must have to participate in the Health Home program.
- Medicaid Recipient
- There are no age restrictions for this service
- Providers may work with parents, guardians, or POA’s to support a person in meeting their health goals
- Have a chronic condition
- This can be physical, emotional, or developmental
- Have a PRISM score of 1.5 or higher
- PRISM is the Predictive Risk Intelligence System
- State managed database that generates a score based on information from medical, social service, behavioral health, and long-term care data directly related to a person’s care.
How to Refer to a HHCC Program
The process can be completed through the individuals Medicaid Managed Care Organization (MCO)
- The potential client can contact the MCO and verbally request the service
- A provider may contact them and ask for specific steps in how to refer to that program. These steps can vary depending on the MCO.
- The MCO is generally the Lead agency that oversees the HHCC service and will review a person’s eligibility for referral.
- If the MCO is not the Lead agency, they will provide the referral information to the Lead agency in that region that has been contracted to oversee HHCC services.
- The Lead agencies provider oversight based on State Region Location available for duel enrolled individuals (Medicaid-Medicare) – Provided they do not have Medicare Part C
