Maine DHHS Now Accepting Applcations for Opioid Health Homes
MaineCare's new Opioid Health Home (OHH) program has begun accepting applications from organizations wishing to be considered for the designation.
The Opioid Health Homes are a new component of MaineCare’s Value-Based
Purchasing Initiative, providing counseling, care coordination,
medication-assisted treatment, peer support and medical consultation for
individuals who have been diagnosed with an opioid dependency.
This OHHs will provide services to MaineCare members and the
uninsured through grant-funded contracts with the Department of Health and
Human Services’ Office of Substance Abuse and Mental Health. The upcoming application and the program
requirements apply to programs serving both the MaineCare population and the
uninsured (with a few minor exceptions).
To be an OHH, an organization must:
- Be currently using an Electronic Health Record (EHR)system;
- Have a full team at time of application, to include at least
the following personnel:
- Clinical Team Lead;
- Medication-Assisted Treatment Provider;
- Nurse Care Manager;
- Certified Clinical Supervisor;
- Licensed Alcohol and Drug Counselor; and
- Peer Recovery Coach.
- Have full implementation of the Core Standards as evidenced by
reporting examples of current work for the following:
- Demonstrated leadership;
- Team-based approach to care;
- Population risk stratification and management;
- Enhanced access;
- Practice integrated care management;
- Behavioral-physical health integration;
- Inclusion of patients and families;
- Connection to community resources and social
- Commitment to reducing waste, unnecessary
healthcare spending, and improving cost-effective use of healthcare
- Integration of health information technology
(Access to HeathInfoNet for OHHs serving uninsured members).
- Demonstrate that they:
- Can monitor treatment adherence and sustain
recovery for their OHH members;
- Have an infrastructure within the organization to
perform population risk stratification and population management; and
- By using a report, have a way to track their own
performance over time.
More information is at http://www.maine.gov/dhhs/oms/rules/emergency.shtml.
There are two options for reimbursement:
- Option A: Opioid Health Homes directly administering
buprenorphine, buprenorphine derivatives and naltrexone in an office
setting with a pharmacist on site will be reimbursed at a rate of $1,000
per member, per month.
- Option B: Opioid Health Homes providing a prescription
for buprenorphine, buprenorphine derivatives and naltrexone to be filled
at an outside pharmacy will be reimbursed at a rate of $496 per member,
(Thanks to Dr. David McDermott and the Maine Hospital Association)