The West Virginia Bureau for Medical Services (BMS) is developing a Health Home Model to coordinate care for Medicaid members with various identified conditions and risk factors. A Health Home provides a comprehensive system of care coordination for Medicaid members with chronic conditions. Health Home providers will coordinate all primary, acute, behavioral health and long-term services and supports to treat the “whole person” across his/her lifespan. Health Homes have been shown to increase patient’s health and reduce medical costs. Since the focus is on the whole patient, all of the health care providers a patient sees are part of his/her treatment team. Members will be assigned to a Health Home but can opt-out. The implementation will be an incremental rollout (phase-in) of conditions and geographic areas.