Health Homes for Professionals
Have a patient struggling to follow up with their care? Refer them to our Health Homes program today!
What is Health Homes?
Health Homes is a free, voluntary care coordination program that helps promote and facilitate communication among all health care professionals involved in a patient’s care. Health Homes helps to make sure that all of a patient’s health, mental, and social services needs are met.
How do providers refer patients to Health Homes?
Health Homes clients must be:
- on Medicaid
- have at least two chronic conditions; or one serious mental illness; or HIV
How can Health Homes help patients? We will:
- Assess and assist with psychosocial needs. This includes helping a patient find housing, entitlements, legal, education and community support services.
- Give patients appointment reminders
- Have staff accompany patients to appointments
- Link patients to mental health and drug abuse services
- Reach out to patient’s providers to discuss treatment plans
- Help patients with hospital discharge and planning
- Set up transportation to appointments if needed
- Help patients avoid emergency room visits
- Provide crisis intervention
- Help patients navigate health and social services and link patients to providers
- Include providers in a patient’s care plan goals
- Give providers updates on a patient’s progress by phone and at appointments
A patient must have documentation of illness when they are referred to Health Homes.
If you want to refer a patient, call us at 1 (855) 246-4422.