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Health Homes Model

The Medicaid Health Homes program is designed to coordinate healthcare and social services for Medicaid and Medicare-Medicaid dual eligible individuals with chronic conditions and mental or behavioral health problems.

The key components of the Health Home model are:

  • Comprehensive care management
  • Care coordination
  • Health promotion
  • Comprehensive transitional care including follow-up from inpatient and other settings
  • Patient and family support
  • Referral to community and support services

The Rural Care Coordination Toolkit contains information about Health Homes.