Community Programs and Services

NewYork-Presbyterian Ambulatory Care Network

Health Home

What is a Health Home?

A Health Home is an intensive care management service program for Medicaid patients with complex and high-cost medical conditions to address their medical, behavioral and social needs in a comprehensive manner. Each patient is assigned a care manager who oversees and facilitates access to appropriate services, including community-based resources. The care manager, patient, and professionals involved in the patient’s care work closely together to develop a patient-centered care plan that empowers the patient to be an active participant in his/her health care.


What are the goals of Health Homes?

  • Improve patient’s overall wellbeing and ensure patient stays healthy
  • Reduce unnecessary emergency department visits, inpatient stays, and use of long-term care services through care coordination
  • Facilitate exchange of patient health information among providers to minimize duplication or neglect of services
  • Ensure patients have access to the resources and tools, including social service programs, needed to become and remain healthy