Washington Health Home Program

The 2021 State Legislature provided a remedy for lead agency reimbursement issues that created a barrier for contracting with Tribes.  The HCA and the Department of Social and Health Services, Aging & Long-Term Support Administration (ALTSA) have prepared a Tribal Care Coordination Organization Agreement (CCOA) for use by all Health Home Lead Organizations. Because your Tribe either has an existing Health Home contract or has expressed an interest to learn more on how to become a Health Home Care Coordination Organization, we are seeking your input prior to finalizing the Tribal CCOA template for all Lead Health Home organizations to utilize when contracting with interested Tribal Governments.

Health Home Care Coordination Organization Agreement (CCOA) Tribal Addendum

Health Home CCOA Tribal Addendum 12-16-2021

Achieving Washington State's Vision of Integrated Services

The Department of Social and Health Services and the Health Care Authority have collaborated on the Health Home Program with federal partners since 2013, and have received strong support from individuals, local health care providers, and advocates.

Washington has targeted its demonstration to high-cost, high-risk Medicare-Medicaid enrollees based on the principle that focusing intensive care coordination on those with the greatest needs provides the greatest potential for improved health outcomes and cost savings. The positive outcomes achieved by a previous State Chronic Care Management Program led Washington to adopt a comparable model, organized on the principles of patient activation and engagement. In the course of integrating care for enrollees across multiple delivery systems, Health Home Care Coordinators are charged with engaging enrollees to set health action goals and increase self-management skills to achieve optimal physical and cognitive health.

All Care Coordinators receive intensive training on how to develop the Health Action Plan and the six Health Home services.  Health Home seek to address complex health issues by offering:

  • comprehensive care management;
  • care coordination;
  • health promotion;
  • comprehensive transitional care and follow-up;
  • individual and family support; and
  • referrals for community and social services support.

Care Coordinators work to reduce gaps in services and increase coordination of all service providers including medical, behavioral health, long-term services and supports, and other social services.

The goal of the Health Home Program is to improve coordination of care, quality, and to increase an individual’s participation in their own care. Care Coordinators do not duplicate or replace services that individuals are receiving. Participation in the Health Home Program is voluntary and will not change or replace any services and supports the individual is receiving; it is simply an added benefit.

In addition, Washington has been participating in the CMS Medicare-Medicaid Financial Alignment “Demonstration” for individuals who receive both Medicaid and Medicare benefits (commonly referred to as dual eligible).  Participation in the Demonstration has been a unique opportunity for the state to receive performance payments from CMS based on achieving statistically significant savings and meeting or exceeding quality requirements.   

Under the Demonstration, the state may ultimately share up to half of the gross Medicare Parts A & B savings after final analysis of Medicare and Medicaid data for both years is complete.   In the first year of the Demonstration, HCA received a preliminary payment from CMS of $11.6 million. For the second year, the state received a $10.7 million preliminary payment.

Duals Financial Alignment Demonstration Activity


Memorandum of Understanding with CMS                                      


 State Plan Amendment Approval                                                      


 Final CMS Agreement                                                        


Extension of Demonstration through 2018


Phase One Implementation


Phase Two Implementation


Received Year One shared savings

June 2016

Phase Three Implementation (statewide)


Received Year Two shared savings

June 2017

Extension of Demonstration through 2020


For more information about the Health Home Program