Medicaid health homes, made possible through the Affordable Care Act, provide states with a mechanism to support better care management for people with complex health needs with the goal of improving health outcomes and curbing costs. States implementing health homes receive enhanced federal support for a limited time period. As of March 2014, 15 states have 22 approved state plan amendments to implement Medicaid health homes. Six “early adopter” states — Iowa, Missouri, New York, North Carolina, Oregon, and Rhode Island – have collectively enrolled more than 875,000 Medicaid beneficiaries in health homes.

This CHCS brief, supported by the New York State Health Foundation and the Missouri Foundation for Health, draws from the experiences of early health home adopter states to outline elements critical to implementation and sustainability of this new model. The brief informs other states looking to develop effective health home programs.