Health homes are a proven team-based model for delivering the required range of health care services in a more coordinated and effective manner.
Research shows that children who have a health home are less likely to have unmet health needs and are more likely to have annual preventive visits; however, only 45% of California children received coordinated care through a health home, ranking California 2nd to last among all states. California children in poverty are even less likely to receive coordinated care through a health home, with only 25% of them receiving such care.
Through collaboration and information sharing, health homes increase communication and coordination and can thereby reduce errors and costs. Common reasons for medical errors and increased costs include poor communication and lack of coordination between health care professionals. It is estimated that approximately 700 California patients die each year because of preventable medication errors. Children are at the greatest risk for medication errors. Additionally, in 2011, inadequate care coordination was responsible for over $25 billion in wasteful spending nationally.
Evidence suggests that health homes decrease costs by reducing the number of inpatient visits, emergency room trips and hospital re-admissions. For this reason, health homes are especially beneficial to children with special health care needs or chronic conditions, such as diabetes or asthma. For example, in one study of a health home program for asthmatic children, asthma-related emergency room visits decreased by 63% and hospitalization rates decreased by 62% over a 3-year period.
California should establish a coordinated and comprehensive health home for every child. Health homes show strong potential to create cost savings for the state and improve children’s health over a lifetime. The federal health care reform law provides an opportunity for California to develop health homes using 90% federal matching funds. The state has evaluated this option and now should move forward quickly toward implementing a child-centered model. California should also ensure all health care systems, including health homes, incorporate technological advances such as electronic health records to deliver the best care to patients and use doctors’ time most efficiently.
Federal health care reform gives California the opportunity to develop health homes using 90% federal matching funds, the remaining 10% could be financed through private funding. Particularly in light of the successful implementation of health homes models in other states under health reform, this is an opportunity that California cannot afford to miss.
The state is seeking funding from the federal government for a California State Innovation Model (CalSIM) initiative, which would test whether new payment and service delivery models improve health and health care delivery and reduce costs. Health home models are an important part of the CalSIM effort.
California Children’s Services (CCS) is a state program that provides services to children with serious conditions such as cystic fibrosis, heart disease and cancer, up to age 21. Given their complex health care needs, children enrolled in CCS could benefit greatly from the health home model. California’s Department of Health Care Services is evaluating whether to create a health homes program to serve the CCS population.