Both Saratoga and Schenectady counties will be among the first in the state to enroll Medicaid patients into what will be known as a “health home.” Health homes, by no means an actual, physical home, will instead act as a community-based network of health providers, coming together to better coordinate the care of patients with chronic or reoccurring health 

conditions.

“The health home looks to incentivize a community to take a more long-term approach in the care management of an individual, especially for those with chronic illnesses or individuals who are at a high risk for admission and readmission into a hospital,” said Joseph Twardy, president and CEO of the Visiting Nurse Service of Schenectady and Saratoga Counties (VNS). “It’s a much more holistic approach to health care.”

VNS is one of several organizations leading the way to create the area’s local health homes. Once established, Twardy expects a network of some 600 local care facilities, all coordinating with one another and sharing information to better treat the patient, instead of treating the isolated conditions. By taking a larger view at how to treat a subject, the hope is not only for better care that avoids conflicts and duplication, but also one that reduces expenses drastically. 

“I think the savings will far exceed even the $20 million number that’s been given with what we’re bringing to the table,” said Twardy.

Health homes have been designed to address two components of the nation’s health care system: quality of care and cost. Eventually all Medicaid patients will be enrolled into a care management health home, but for now the focus is on the 20 percent of patients across the country that total up to 80 percent of the cost in the health community.

“The health home initiative is about better care, but it’s also about the spike and continuing upward trend in the cost of care. We have to bend that cost curve, so to speak, and the health home initiative will do that,” said Twardy. “It’s a low-cost program with the better coordination of care that will reduce the duplicative tasks, will avoid more costly care over less costly preventative care, and will coordinate resources between organizations to again avoid duplication.”

Preventive care measures include anything from helping to design a healthy and sustainable diet, linking individuals to social and support programs for mental illness or substance abuse, and ensuring that patients actually attend their scheduled appointments with physicians.

“Care management is at the core of what the health home will provide,” said Twardy.

Several local health care institutions have already filed letters of intent with New York State indicating their interest in becoming a member of a community home health network. Local organizations include Saratoga Hospital, Glens Falls Hospital, Seton Primary Care, Hometown Health Centers and Ellis Medicine.

“We’ll provide the right care in the right place, reducing hospital readmissions and resulting in the more effective use of the emergency department,” said Ellis Medicine President and CEO James W. Connolly. “By improving access to care and providing better coordination of care, this model has the potential to improve the health and well-being of our entire community in the years to come.” 

Other organizations, such as CDPHP, MVP Healthcare and Fidelis have also sent the state letters of intent to join the health 

networks.