Provider Support Helping Members

Health Homes

Health Homes Program

The California Department of Health Care Services (DHCS) has contracted with Anthem Blue Cross (Anthem) to implement the Health Homes Program (HHP) in California. The HHP will serve eligible members enrolled in Medi-Cal Managed Care with complex medical needs and chronic conditions who are frequent utilizers and may benefit from enhanced care management and coordination.

The HHP provides six core services:

  1. Comprehensive care management
  2. Care coordination (physical health, behavioral health, community-based long-term services and supports)
  3. Health promotion
  4. Comprehensive transitional care
  5. Individual and family support
  6. Referral to community and social support services
What is the HHP?

The HHP is a personalized approach to health care. It focuses on people, not their conditions. It’s like having a guide to walk eligible members through the complex health care system — keeping track of all their health and service needs, and communicating with their providers. A designated care coordinator provides support to the members and their caregivers by helping arrange the care and services they already get, and by finding even more supports, such as:

  • Arranging transportation to and from their doctor visits.
  • Scheduling doctor appointments and services
  • Finding supports close to the members.
  • Answering questions about their health and services, and much more.
Member eligibility

To be eligible, members must meet at least one requirement in each section below.

Section 1:
  • At least two of the following: chronic obstructive pulmonary disease (COPD), diabetes, traumatic brain injury, chronic or congestive heart failure, coronary artery disease, chronic liver disease, chronic renal (kidney) disease, dementia, substance use disorders.
  • Hypertension and at least one of the following: COPD, diabetes, coronary artery disease, chronic or congestive heart failure
  • At least one of the following: major depressive disorder, psychotic disorders (including schizophrenia)
  • Asthma
Section 2:

Members must meet at least one of the following acuity/complexity criteria below:

  • Has at least three or more of the HHP-eligible chronic conditions
  • Has had at least one inpatient hospital stay in the last year
  • Has had three or more ER visits in the last year
  • Has chronic homelessness
Where will the HHP be implemented?

Anthem works with multiple Health Homes providers that vary by location. Effective July 1, 2018, the program is now being offered in San Francisco County. On July 1, 2019, the program will be offered in the following counties:

  • Santa Clara County
  • Alameda County
  • Los Angeles County
  • Sacramento County
  • Tulare County