Behavioral Health Homes and Opioid Health Homes
Health Home services include care coordination, case management, individual and family support, and health promotion/education. Each organization that is partnering to provide health home services receive a per member, per month (PMPM) payment.
Participation in any of the three health home programs is voluntary, and members can opt out of the service at any time.
Community Care Teams
Community Care Teams (CCT) are organizations who partner with primary care practices and community providers to support members with certain chronic conditions and who are at risk of poor health outcomes and/or high utilization of health care services. Housing Outreach and Member Engagement Provider (HOME Provider) is a specialized CCT that provides housing outreach and member engagement services for eligible members with Long-term Homelessness.
Community Care Teams, including provider requirements, are further described in the MaineCare Benefits Manual.
Accepting HOME Applications
The HOME Provider application is open. To apply, please use our online application.
Community Care Teams, including provider requirements, are further described in the MaineCare Benefits Manual, Chapter II and Chapter III, Section 91.
Materials, Forms, and Other Resources
Behavioral Health Homes (BHH)
Behavioral Health Homes are a partnership between a licensed community mental health provider (the Behavioral Health Home Organization or BHHO) and one or more Health Home practices to manage the physical and behavioral health needs of eligible adults and children. Behavioral Health Homes build on the existing care coordination and behavioral health expertise of community mental health providers.
Behavioral Health Homes, including provider requirements, are further described in the MaineCare Benefits Manual.
Accepting Applications
The Behavioral Health Home application is open. To apply, please use our online application.
Pay-for-Performance
In April 2018, a Pay-for-Performance (P4P) provision for Behavioral Health Home (BHH) providers was implemented, placing one percent of total BHH payments at risk pending performance on a quality measure.
The current quality measure is as follows: Of the MaineCare members assigned to the BHHO who had two or more fills of antipsychotic medication, the percentage of members who had at least one HbA1c or fasting blood glucose test. This measure was designed based upon the American Diabetes Association’s (ADA) recommendation: "Annually screen people who are prescribed atypical antipsychotic medications for prediabetes or diabetes." (Diabetes Care 2004 Feb; 27(2): 596-601. http://dx.doi.org/10.2337/diacare.27.2.596 / as amended 2010). The performance threshold for the quality measure has been set at 70%.
More information on the performance measure and P4P provisions can be found in the MaineCare Benefits Manual.
Materials, Forms, and Other Resources
In order to provide Behavioral Health Home (BHH) services, providers must first meet the guidelines established by MaineCare and Children’s Behavioral Health Services (CBHS) for provision of Targeted Case Management (TCM). Providers may choose to provide either TCM or BHH services or to provide both services. Please click on the link below to locate providers that have been approved to provide Section 13 TCM services for CBHS, these providers will be listed as providing services for children.
Questions?
Email the BHH email box for questions about the project, upcoming events, and meetings.
Opioid Health Homes (OHH)
Opioid Health Homes (OHH) deliver team-based treatment of opioid use disorder including medication, opioid dependency counseling, and comprehensive care management for eligible MaineCare members and uninsured individuals.
The OHH model utilizes team-based care to support both the individual in treatment as well as the providers delivering care.Opioid Health Homes, including provider requirements, are further described in the MaineCare Benefits Manual.
Accepting Applications
The Opioid Health Home (OHH) application is open. To apply, please use our online OHH application.
Resources
- List of Opioid Health Homes by County (PDF)
- Map of Participating Opioid Health Homes
- OHH Questions & Answers (PDF)
- OHH P4P benchmark announcement 2023 (PDF)
Questions?
For questions pertaining to the Opioid Health Homes, please contact the Opioid Health Home email box.
Health Homes Forum - November 2020
During the November 2020 Health Home Virtual Regional Forums, we shared recorded intake presentations from OHH and BHH providers, and a Community Care Team (CCT). We hope that these videos are helpful as you develop staff training for these programs: