AHI Health Home

AHI is a New York State-designated lead Health Home and serves all ages. A Health Home is not a place; it is a care management service that connects community and social supports with health care, and provides better organization of medical and behavioral health care. A Health Home ensures all caregivers involved with a person talk to one another so they can focus on their client’s needs.

Our Role

We coordinate medical and behavioral health care by connecting community and social supports with health care for high-risk Medicaid members with:

  • HIV/AIDS; or
  • a serious persistent mental illness; or
  • two or more other chronic conditions (e.g., mental health condition, substance use disorder, asthma, diabetes, heart disease, body mass index (BMI) greater than 25, or other chronic conditions).

Additionally, any of the following risk factors must be a part of the person’s situation. These reasons include, but are not limited to:

  • Homelessness or risk of homelessness;
  • Lack of social/family supports;
  • Deficits in activities of daily living;
  • Non-adherence to treatments;
  • Learning or cognitive issues.


The AHI Health Home goal is to improve care coordination for high-risk Medicaid individuals, reduce duplicate services, reduce ER visits and inpatient admissions, and lower costs.

The AHI Heath Home is a partnership of primary care providers, hospitals, and several behavioral health and community-based organizations.

“Care management is very individualized depending on what services you need – and extremely caring, compassionate and professional.”

– Health Home client

Learn More

Watch this introductory video on the AHI Health Home – what it is and the benefits it offers – for prospective enrollees.


Complete the AHI Health Home Community Referral Form.

Read Success Stories to see how the AHI Health Home has impacted the lives of our community members.

Contact Us for more information.

Share the AHI Health Home Brochure.
Share the AHI Health Home Serving Children Brochure.