Implementing a Health Home: Michigan's Experience

As the number of individuals in the United States with chronic conditions and the associated costs in caring for these individuals continues to rise, there is a need to transform how health care services are delivered. Under Section 2703 of the Affordable Care Act of 2010, the federal government provides state Medicaid programs the opportunity to improve care coordination for people with chronic conditions in a person-centered approach through the establishment of health homes. Given the complexity of care for Medicaid beneficiaries with chronic conditions, addressing the social determinants of health and providing integrated care are central to effectively improving health outcomes and generating cost-savings. Although launching a health home model is a step toward improving care coordination and care management for high-risk individuals, there are myriad components to implementing such a program. The purpose of this article is to explain the process that Michigan policymakers undertook to implement its Section 2703 Medicaid health home initiative, named the MI Care Team. The authors present lessons learned for policymakers and stakeholders in other states seeking to implement a Medicaid health home and explain how the nursing profession is integral for health homes.