The Urban Institute’s final report on its 5-year Medicaid health home evaluation examines effects on utilization and spending in Missouri’s two programs and summarizes qualitative findings for 11 states over their first two program years. Missouri realized some successes and movement toward health home goals. We found Medicaid savings for enrollees with longer program exposure in some cases and no increase in overall spending, but not the hoped-for facility-based spending reductions. Qualitative findings summarize implementation challenges the 11 states reported, key factors for success, and almost universal stakeholder assessments that the program improved enrollees’ care. Created by the Affordable Care Act, health homes focus on high-cost, high-need populations, integrating physical and mental/behavioral care, and coordinating care encompassing medical services and community supports. The USDHHS Assistant Secretary of Planning and Evaluation supported the research.
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