Visiting Nurse Service

Health Home

A health home is not a building; it is a new care management model designed by Medicaid to help high risk patients. A health home consists of providers and community agencies that collaborate to provide services to people with Medicaid coverage who have a serious mental illness or two chronic conditions. It enables patients to be healthier and safer in the community.

How does a health home work?

A care manager typically oversees all needs of client care, and everyone involved—including the client—has input into the care. The health home care manager addresses the patient’s needs, including medical needs, behavioral/mental health needs, chemical dependency, and psychosocial needs including housing, transportation and food. Health records are shared among providers so services are not duplicated or neglected, and patients can access a care manager 24 hours a day, seven days a week. Health homes provide more intensive work with patients than usual, and the end goal is for patients to graduate from the program, be well connected to necessary services, and have their health managed by their primary care physicians.

How is VNS involved?

Visiting Nurse Service of Rochester is one of the agencies that provides care management for the health home named Greater Rochester Health Home Network (GRHHN). We also provide home care services for both GRHHN and Health Home of Upstate NY (HHUNY).

How can I involve my patients?

If you have a Medicaid patient who would benefit from enhanced case management, contact us today. We will evaluate whether the patient meets the State’s criteria and contact GRHHN. You do not have to sign orders. Call Visiting Nurse Service today at (585) 787-8320.

Health Home Referral Form

Health Home Fact Sheet for Clients

How can I learn more?

To learn more about health homes, visit the New York State Department of Health’s website

Visiting Nurse Service of Rochester
(585) 787-2233
(800) 724-5727

2180 Empire Boulevard • Webster, NY 14580


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