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Health homes reduce emergency visits, improve coordination, presenters tell House subcommittee
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Summary
Presenters from Central Wellness Network told the House Appropriations Subcommittee on Medicaid Behavioral Health that Michigan's health home model coordinates care for Medicaid enrollees, produced reductions in emergency-department use, and uses a per-member-per-month payment with a 5% value-based withhold tied to performance metrics.
At a meeting of the House Appropriations Subcommittee on Medicaid Behavioral Health, staff from Central Wellness Network described how Michigan's behavioral health home and substance use disorder (SUD) health home programs coordinate care for Medicaid enrollees and reported regional enrollment and outcome data.
Tricia Polczyk, clinical director of adult services at Central Wellness Network, told the subcommittee that as of 03/12/2026 her region had 976 people enrolled in the SUD health home and 716 in the behavioral health home; statewide, she said, there were 4,243 SUD health-home enrollees and 3,278 behavioral-health-home enrollees. Polczyk said her region represents roughly 23% of statewide SUD enrollments and about 21.8% of behavioral-health-home enrollments.
Jessica Hugard, the network's medical services supervisor who oversees health-home programs, outlined the model's six core services: comprehensive care management, transitional care management, care coordination, individual and family support, health promotion, and referrals to community supports. She said the lead on care teams is an RN care manager who coordinates with medical and behavioral-health providers, peer supports and community partners.
Hugard described the payment structure as a per-member-per-month payment for each enrolled beneficiary who receives at least one eligible service in a month, with a value-based component that includes a 5% withhold tied to performance metrics. She said pay-for-performance funds are reinvested in local supports and gave examples including outreach events, self-management tools (blood pressure cuffs, pulse oximeters) and help covering co-pays and essentials.
Presenters said regional data show decreased emergency-room utilization and improvements in overall risk scores and several chronic conditions (diabetes, high blood pressure, asthma and obesity). They cautioned that the region's results are not benchmarked against statewide averages in the packet shown to the committee and that numeric performance reports are compiled by the regional entity; they offered to provide the committee the specific metric values on follow-up.
Committee members asked whether the program is a building-based service and how it differs from other models such as CCBHCs. Polczyk and Hugard emphasized that health homes are a benefit and a model of coordinated care rather than a facility; Hugard said Central Wellness Network has rebranded its BHH program locally as "Be Healthy Here." They noted the model is particularly valuable in rural counties such as Manistee and Benzie, where provider shortages, transportation barriers and unreliable broadband reduce access to specialty care.
On staffing and service intensity, Hugard said enrollment requires a substantial initial visit (about one to three hours) to complete assessments and a care plan; subsequent contacts vary widely from brief 10'15 minute check-ins to multi-hour coordination tasks, with a rough average of two to three hours of staff time per client per week. She said average enrollment commonly ranges from a year to two years and that clients who meet goals may be disenrolled.
The presenters cited operational challenges including workforce recruitment and retention (particularly nursing staff), technology limits for telehealth, and stigma that affects engagement. They also described partnerships with probation and parole officers and jail health providers to maintain medication continuity and plan reentry services for clients who are incarcerated.
In response to a committee question about a recent decline in SUD enrollments, presenters attributed part of that decline to Medicaid redeterminations that resumed after the pandemic and to several new community partners offering medication-assisted-treatment services in the area. When asked which PIHP (prepaid inpatient health plan) is not participating, Polczyk said she did not know and offered to follow up with the committee.
Members also asked about uses of pay-for-performance funds; Hugard confirmed that the network has used some funds to purchase items such as tents and winter boots for people experiencing homelessness when shelter beds were unavailable, saying, "Obviously, a tent is not ideal, but it's better than nothing." The presenters said pay-for-performance awards have supported community education events, quarterly health groups and devices that support self-management.
The presenters identified MDHHS handbooks as the guidance source for behavioral-health-home measures; they said regional entities compile metric reports and that some data elements originate from CMS sources but that MDHHS provides the handbook metrics that guide the program.
The subcommittee did not take formal policy action on the presentation. Members requested numeric performance data and a follow-up on PIHP participation; the presenters agreed to provide that information.
