Rhode Island Health Homes

Program Location: 
Providence, RI
Payer Type: 

Rhode Island has 3 approved 2703 Health Home State Plan Amendments.

The Rhode Island CEDARR Family Center Health Home State Plan Amendment was approved in November of 2011 and offers health homes to Medicaid enrollees with 2 chronic diseases, one chronic disease and at-risk for developing a second, or a serious mental illness. It also expands the SPA definition of "chronic disease" to include Developmental Disability, Down Syndrome, Mental Retardation, Seizure Disorders. CEDARR Family Centers focus on children and youth with special health care needs (cyshcsn) and are designed to provide a structured system for facilitating the assessment of need for, and the provision of high quality, evidenced based Medically Necessary services.

The Rhode Island Community Mental Health Organization (CMHO) Health Home State Plan Amendment offers health home services to Medicaid enrollees with a serious mental illness or a mental health condition. Rhode Island has seven CMHOs, which along with two other providers of specialty mental health services form a statewide, fully integrated, mental health delivery system, providing a comprehensive range of services to clients.

The Rhode Island Opioid Treatment Program Health Home State Plan Amendment offers services to Medicaid enrollees with Substance Abuse Disorder. Opioid Treatment Programs provide the opportunity for daily contact with Medical and Clinical professionals who have on-going therapeutic relationships with patients. This will enable providers to use existing and enhanced resources to improve the health of patients and decrease inadequate/ineffective medical care. 

Payment Model: 

CEDARR Family Center Health Home: In 2009 Fixed Rates were developed for three CEDARR Services; Initial Family Intake and Needs Assessment (IFIND), Family Care Plan development (FCP), and Family Care Plan Review (FCPR).

CMHO: The State will establish a fee structure designed to enlist participation of a sufficient number of providers in the Health Homes program so that eligible persons can receive the services included in the plan, at least to the extent that these are available to the general population.


Increased Preventive Services: 

Rhode Island will use claims and encounter data, intake surveys of CMHO clients, chart reviews, and the RHode Island Behavioral Health Online Database to evaluate progress toward the state's six goals for this state plan amendment: Improve care coordination; Reduce preventable emergency department utilization; Increase preventive services utilization; Improve management of chronic conditions; Improve transitions to community mental health organzation services; and Reduce hospital readmissions.

Last updated June 2019
Go to top