Health Care Innovation Awards: Project Profile


Project Title: "Community-based health homes for individuals with serious mental illness"
Geographic Reach: Massachusetts
Funding Amount: $2,942,962
Estimated 3-Year Savings: $3,792,020


Vinfen Corporation, in partnership with Bay Cove Human Services, North Suffolk Mental Health Association, Brookline Mental Health Center, Commonwealth Care Alliance, Robert Bosch Healthcare, and Dartmouth University received an award to integrate primary and behavioral health care for individuals with serious mental illness in the metropolitan Boston area. The project embeds Nurse Practitioners, backed by a primary care physician, into existing community based psychiatric rehabilitation and recovery teams, creating community based health homes that provide better care at lower cost for a population at risk for severe chronic disease. Embedded Health Outreach Workers teach participants to manage their behavioral and physical health effectively and more independently. This care team uses telehealth technology to monitor participants' signs and symptoms, prioritize care and deliver necessary interventions. As a result, the project aims to improve the health of participants, increase their access to primary and specialty health care and reduce the use of costly acute care services.

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