For New York Health Home care-management agencies
One missed contact turns an HH+ month into a High Risk month. Kept Count shows every care manager's capture before the month closes, not after the remittance arrives.
A Health Home month is a cliff, not a slope. Miss the HH+ minimum and the month does not fail. It quietly pays the High Risk rate, downstate more than five hundred dollars less on the same member for a documentation reason. Kept Count counts the six core services and the face-to-face contacts as they happen, shows each care manager which members are short with days left in the month, tracks the plan of care against its sixty-day deadline, and exports the closed month as CSV or XLSX.
Public evaluation uses synthetic data. Kept Count is designed for covered operation, and business associate agreements are executed per customer before live patient use.
What pays you
The codes and tiers behind the month.
Health Home pays per member per month by tier, and the tier a month actually pays at is decided by a contact count, not by effort. These are the adult tiers the state publishes.
Rate code 1853
HH+ care management
$925.28 downstate, $867.45 upstate
Per member per month. Requires 4 core services in the month, 2 of them face-to-face.
Rate code 1876
HH+ assisted outpatient treatment
$1,115.19 downstate, $1,046.64 upstate
Per member per month. Requires 4 core services, all 4 face-to-face.
Rate code 1874
High Risk / High Need care management
$386.83 downstate, $363.60 upstate
Per member per month. Requires at least 1 core service. This is also where an HH+ month lands when it misses its minimum.
The downgrade
HH+ month that misses its minimum
$538.45 lost downstate, $503.85 upstate
The month does not fail. It quietly pays the High Risk rate for a documentation reason, and nothing in the remittance says why.
Children's Health Home
Tiers by CANS-NY acuity
Per your fee schedule
Counted and classified, never priced here. Below the acuity minimum a children's month is a true zero, not a downgrade, and a CANS-NY that slips past month two blocks billing entirely.
Published New York State Department of Health Health Home rates, rate cycle 2511, effective April 1, 2025. A later rate column is posted pending federal approval and is deliberately not shown. Verify against the current fee schedule before relying on any figure. Children's Health Home tiers are counted but never priced on this site.
How the month runs in Kept Count
One month, start to packet.
Each step is shown on synthetic data. Your roles, your rules, and your month close run the same way in the workflow session.
- 01
Enroll the segment with its tier, region, and minimum
Each member carries a segment type, upstate or downstate, and the minimum that tier requires. HH+ needs four core services with two face-to-face. AOT needs four, all face-to-face. The minimum is the rule the month is measured against from day one.
Synthetic data - 02
Count core services as they happen
Care managers record each of the six core services against the member with a server timestamp and whether it was face-to-face. A minute of documented time that contains no core service counts for nothing, and the worklist says so.
Synthetic data - 03
See who is short with days left
The capture view shows every care manager's members as met, short, or at risk of downgrade, ranked by the dollars at stake. A supervisor can move a face-to-face into the last week instead of learning about the shortfall in the remittance.
Synthetic data - 04
Track the plan of care and consent deadlines
The sixty-day plan-of-care clock, consent, and the CANS-NY gate for children's segments run beside the month. A deadline surfaces while it can still be met.
Synthetic data - 05
Close the month and export it
Month close records each member-month at the tier it actually cleared, with the services behind it, and exports CSV or XLSX for your billing workflow. You upload the file. Kept Count never submits anything.
Synthetic data
Proof that applies to you
Tested in the open, on synthetic data, before any customer.
Every claim below is checked in the codebase and documented on the proof page. None of it is a customer result, and none of it is a promise of payment.
10,000 synthetic members, 29,100 patient-months
A certified synthetic run of the full platform: 24 navigator panels capped at 250, every expected code and hold reason matched, zero patient rows visible across panels or organizations.
Append-only audit trail
Consent, assignment, role, and approval events are recorded with who acted and when. The log rejects edits and deletions, including by the table owner.
Row-level security on every table
Access is checked at the database, scoped to the organization that owns the row. No table relies on an open policy.
Fresh-database replay in the release gate
Every migration replays in order against a brand-new disposable database in continuous integration, then runs the security tests, before a release is trusted.
What Kept Count will never do
The boundaries are the product.
Care-management software earns trust by making responsibility easy to inspect. These are the lines Kept Count holds for you, on purpose.
Kept Count never pitches a bigger caseload
Caseload ratios are set by the state. Kept Count raises the share of a caseload that clears its tier, not the number of members per care manager.
Kept Count never submits to the state
Closed months leave as a file you review and upload. There is no integration that submits on your behalf and no claim that leaves without a person deciding it should.
Kept Count never prices what the state has not published
Children's Health Home tiers are counted, never priced. An unverified rate fails closed rather than being approximated, because reporting revenue for a month New York does not permit is worse than reporting nothing.
Questions this buyer asks
Answered directly.
We already document in our care-management system. Why add this?
Your system records the work. Kept Count counts it against the minimum while the month is open and shows the shortfall by care manager. If your current system already tells a supervisor on the twentieth which HH+ members are one face-to-face short, you do not need Kept Count.
Does this replace our reporting to the state?
No. Kept Count exports the closed month as CSV or XLSX for your existing billing workflow. There is no submission integration, by design.
How is the downgrade figure calculated?
From the published state rates for your region: the HH+ rate for the tier less the High Risk / High Need rate. The rates are data in Kept Count, verified against the current fee schedule, and the figure is shown as exposure, never as revenue you have earned.
What about children's segments?
They are enrolled, classified by CANS-NY acuity, and tracked against the CANS-NY completion gate. They are never priced, because the below-minimum rule for children is a true zero and the acuity minimums are not encoded until verified.
What does our lead entity see?
Only what you and the lead agree to under your network agreement, and only as aggregates: capture and downgrade exposure by agency, with small cells suppressed and no drill-through to a member. Your records stay yours.
Next step
Bring one care manager's caseload and last month's remittance. We will show you which months downgraded and why.
A workflow session runs a sample caseload through the Health Home month on synthetic data. No member information, no agreement, no cost.