Many policymakers and health care payers recognize patient-centered health homes and medical homes as possible solutions to escalating health care costs, fragmented care delivery, and a badly strained primary care delivery system. These strategies can potentially enable more coordinated care, improve health outcomes, reduce avoidable and costly services like emergency department visits and inpatient admissions, provide much-needed financial supports to primary care practices, and ultimately transform primary care delivery. These initiatives vary in design, but generally pay and support health care teams to provide:
- Care management and care coordination;
- Health promotion;
- Transitional care from inpatient and other settings;
- Patient and family support; and
- Referrals to community and social support services.
Policymakers and health care payers across the country are exploring options to invest in these new care models to bend the cost trend. Indeed, health care reform presents an opportunity for Medicaid programs to reimburse for these services for patients with chronic conditions and complex medical and/or behavioral health care needs.
To help stakeholders assess and demonstrate a return on investment (ROI) from health homes and medical homes, the Center for Health Care Strategies (CHCS) developed the ROI Calculator for Health Homes and Medical Homes.
To complete an ROI forecast, you will need to input the following information:
- Timeframe for forecast period and ramp-up
- Size of target population
- Risk-stratification (optional)
- Expected enrollment rate
- Average annual baseline costs for target population, by service category
- Trend (expected growth in health care costs)
- Anticipated changes in utilization patterns
- Estimated program costs
- Discount rate
Help buttons are provided within the Calculator to assist you in developing a forecast.
For additional tips and best practices, a User’s Guide is also available.
The Calculator will automatically save your work when you click on the "Next" button at the bottom of each page.
For more information about CHCS, please visit our primary website at chcs.org.