What is a medical home? It’s a care model that was first introduced by the American Academy of Pediatrics (AAP) in 1967. The initial concept was designed to focus on medical and non-medical care for children with special health care needs. Over time, however, the definition of the medical home has evolved to reflect changing needs and perspectives in health care (www.hrsa.gov). The new focus of the medical home has shifted to include all children and adults, not just children with special health care needs.
In 2007, the AAP joined with the American Academy of Family Physician (AAFP), the American College of Physicians (ACP), and the American Osteopathic Association (AOA) to form the Joint Principals of the Patient-Centered Medical Home (PCMH). The new Patient-Centered Medical Home (PCMH) Model is designed to build a relationship between the patient, family, and providers to help achieve primary care excellence. The Medical Home relies on a team of providers- such as physicians, nurses, nutritionists, pharmacists and social workers- to meet a patient’s health care needs (www.ncsl.org). The goal is to improve access to care, increase care coordination and enhance overall quality, while simultaneously reducing costs.
The seven Joint Principles are: Personal Physician, Physician directed medical practice, Whole-person orientation, Care is coordinated and/or integrated, Quality and safety, Enhanced access and Payment (www.nursingworld.org). The Medical Home can be a physical or virtual network of providers and services. The key to success for this model is health information technology and payment reform. Legislators play a key role in creating and supporting this health care model. Medical Homes use electronic health records to enable communication and information sharing among providers. Additionally, the model offers financial incentives for providers to concentrate on the quality of patient outcomes rather than volume of services.
As of April 2013, 43 states had policies promoting the medical home model for certain Medicaid or CHIP beneficiaries (www.ncsl.org). Not all Medical Homes are alike or use the same strategies; some states have their own pilots and payment structures in an effort to successfully implement the model.
When I think about this model, I see a great deal of value for the patient and his/her family. Having your own network of practitioners that are focused primarily on your medical needs means a great deal. The benefits of having your own team is vital; allowing for extended office hours, shorter waiting times, greater communication with electronic medical access, and direct phone access to help increase communication. The lack of communication from one doctor to another can delay and impact your care. When you have a team of doctors, they are able to coordinate to assist and educate you on the necessary areas of concentration.
The adoption of the Medical Home Model of Care can help the delivery of care. The patient always needs to be the main focus and as a healthcare provider you need to assure the patient’s needs are being met, not only short term, but long term as well. The patient’s care cannot just stop once he/she leave the office, a plan of care needs to be put in place and follow up is required to ensure positive outcomes and quality of care. Whether the patient is sent home, referred to another physician, or sent to a facility, there is a responsibility not only from the provider, but from the patient to follow through on the plan of care that has been prescribed. Having worked in the homecare technology industry for over 6 years, I see a tremendous value in the Medical Home Model. I believe it’s a solid start to a structure that will continue to improve the process and quality of services to the patient, family and physicians.