They say there’s no place like home

The new health reform bill wants to give everyone a home. A medical home, that is.

You may have heard the term before, or heard about PCMHs. That’s the shorthand for patient-centered medical home. But what is it, really?

Essentially, it is a team-based model of care that coordinates primary and specialty care under one umbrella – or home. A primary care, or “personal” physician provides ongoing, and coordinated care throughout a patient’s lifetime to maximize health outcomes, according to the American College of Physicians.

A medical home ensures that patients get suitable care when and where they need and want it in a culturally and linguistically appropriate manner. Medical homes also emphasize enhanced care through open scheduling, expanded hours and communication between patients, physicians and staff, according to the National Committee on Quality Assurance (NCQA). This organization also monitors and evaluates the standards that medical homes must live up to.

The American Academy of Pediatrics says that “Medical homes address preventative, acute, and chronic care …and facilitates an integrated health system with an interdisciplinary team of patients and families, primary care physicians, specialists and subspecialists, other health professionals, hospitals and healthcare facilities, public health and the community.

This team takes collective responsibility for ongoing care for all of the patient’s health needs, or ensures appropriate care is arranged with other qualified professionals. Care is coordinated and integrated across specialists, hospitals, home health agencies, and nursing homes. What this means is that each team member, led by the primary physician is in the loop about issues like co-existing conditions, what drugs the patient is taking, family history of disease, and so on. Health information technology tracks ] tests, results, screenings, preventative therapy, referrals, and follow-ups.

Medical homes use an evidence-based approach, with the appropriate support tools, performance measurement, active patient involvement in decision-making, use of information technology, and an continuous quality improvement process. Payment to the doctors is based on health outcomes – keeping the patient healthy, reducing hospital re-admission rates, preventing disease and fostering better health habits.

So it all sounds good on paper. But does it work?

For the most part, yes. For large practice groups, with a dozen or more providers, this model can work well. Smaller or individual practices may have a tougher time gathering all of the tools and criteria under one roof – it’s possible that several small practices may band together to provide more comprehensive care.

A number of studies have shown that patient centered medical homes improve access to care, information flow among providers, less duplication, and reduced medical costs A study just published in Health Affairs compared a Seattle medical home pilot program to other Group Health clinics. They found that “patients in the medical home experienced 29 percent fewer emergency visits and 6 percent fewer hospitalizations.

More preventive efforts, coordinating care, and making sure patients are active participants in their care and treatment is a good thing. If it catches on nationally, it will become a new model and help reduce health costs. It will also fundamentally change the way healthcare is delivered in the U.S. So the next time you need health care, you might just have to go home.


2 thoughts on “They say there’s no place like home

  1. Liz, Even people with insurance have woes…when companies switch providers,the employees have to sometimes find an entirely new set of doctors, and there goes any continuity. My husband’s employer used to switch providers every year to save money…and sadly those were the good years!

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