Designing Medicaid Health Homes for Individuals with Opioid Dependency: Considerations for States

Although individuals with opioid dependency represent a small percentage of all Medicaid enrollees, they often have significant physical and behavioral health needs that result in high costs of care. States are looking for innovative, cost-effective ways to integrate and coordinate care for this population. Through the Affordable Care Act (ACA), states can implement health homes to provide enhanced integration and care coordination for people with opioid dependency. 

This brief, made possible by the Centers for Medicare & Medicaid Services, highlights key features of approved health home models in Maryland, Rhode Island, and Vermont that are tailored to individuals with opioid dependency. It identifies important considerations in developing opioid dependence-focused health homes, including: (1) leveraging opioid treatment program requirements; (2) promoting collaboration across multiple state agencies; (3) supporting providers in transforming into health homes; and (4) encouraging information sharing.