The Patient-Centered Medical Home

A New Model for Care

• One of the greatest shortcomings of today’s healthcare system is the lack of coordination of care for persons with chronic conditions, such as heart disease, diabetes, cancer, and stroke. Failure to manage care for these individuals effectively often leads to redundant, inappropriate or inadequate care, which increases costs and compromises quality.
  
  
• One of the more promising solutions to managing care more effectively is the patient-centered medical home. The concept has been around for a while, but it is recently regaining attention as a means to address the dual problems of cost and quality. The path from the traditional model to the medical home model is mapped out by the National Committee for Quality Assurance (NCQA). more...
  
  
• The medical home model positions primary care physicians as coordinators of care. They take responsibility for providing for all of the patient’s health care needs or appropriately arranging care with other qualified professionals.
  
  
  • Care Coordination: Each medical home patient has an ongoing relationship with a personal physician who provides first-contact, continuous and comprehensive care which is coordinated across all elements of the health care system.
    
    
  • Quality and Safety: Physician practices operating as medical homes seek optimal patient outcomes through care-planning partnerships among physicians, patients and their families. Doctors follow evidence-based medicine and actively seek patient feedback. A non-governmental entity certifies practices seeking medical home status.
    
    
  • Access: Open scheduling and new communication options enhance patients’ access to their personal physicians and the medical home staff.
    
    
  • Physician Incentives: Medical home payments reflect the value of care management by the physicians and staff beyond face-to-face visits. Additional payments are available for medical home practices that achieve measurable and continuous quality improvements.
  
  
• The patient-centered medical home model has been tested in various regions and has been shown to deliver impressive health care value. The Geisinger Health Care System, for example, has reported that its medical home program reduced hospital admissions in a Medicare population by 20%, saving 7% of total medical costs. Moreover, the program eliminated common healthcare delivery problems including unjustified variation (different approaches to care in different locations), perverse payment incentives (more money for more work with irrelevant outcomes), and lack of coordination among caregivers. (“Continuous Innovations in Health Care: The Geisinger Experience” Health Affairs, Sept./Oct. 2008). See more about Medicare and Medical Home Demonstrations in New York.
  
  
• Click here for some of the health plans that have committed to the medical home model.