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The Medical Home Concept: A Solution For The Healthcare Conundrum?

November 12, 2010 Leave a comment Go to comments

The current monetary number for healthcare spending in the US is 2 trillion dollars, a topic that has created a lot of frustration in our country. At times it seems all we have to show for it is patient confusion over navigating the system, employer and patient agitation over rising costs, and government resistance and aggravation trying to provide affordable access to all. In the last few years, there has been a growing interest in the concept of a Patient Centered Medical Home as a way to combat the ills of the U.S. healthcare system. Proponents of this approach believe the way out of our healthcare conundrum is to make the primary care physician the hub of a patient’s disease prevention and care coordination.

In a medical home model, the primary care doctors and clinicians serve as advocates for patients, helping to avert unnecessary tests and procedures, hospital admissions and avoidable complications. Instead of a payment system that rewards procedures and volume, it would shift to one based on patient satisfaction and clinical outcomes. While few argue with the goals of a patient centered approach to the delivery of healthcare, most agree that transforming the current system would not be easy. Nor is the financial viability of this concept so readily clear.

History of The Medical Home Concept

The origin of the medical home concept goes all the way back to 1967, when The American Academy of Pediatrics used the term to describe a central location for archiving a child’s medical records. In the following decades, medical homes focused primarily on families with children of special needs, helping to coordinate care and information across multiple specialists and services. By the 1990’s, as the delivery of healthcare was becoming more complex, the role of the medical home expanded to include the provision of comprehensive primary care for adults. Associations such as the American College of Physicians and the American Academy of Family Physicians also embraced the medical home concept and issued a joint statement of principles with the AAP in 2007.

Healthcare by ~sciophobik on deviantART

Today, the term “medical home” has become somewhat misleading, as it refers not to a location but to a model based on integrated care across all elements of the healthcare system including hospitals, Nursing Homes, subspecialty care, Home Healthcare agencies, public and private community services and family members. Interest in implementing a Patient Centered Medical Home has been gaining interest among hospitals and physician groups over the last few years based on the summary of several factors. In 2008, Harris Interactive conducted a survey of over 1,000 adults that revealed the current healthcare delivery system does not serve the public well. 8 of 10 respondents said it needs to be fundamentally changed or completely rebuilt.

Specifically, common frustrations voiced by participants in the survey included:

  • Nearly 73% of those surveyed had difficulty making timely doctors’ appointments, getting phone advice or receiving afterhours care without having to visit an emergency room.
  • Approximately 30% reported difficulties getting same or next day appointments with their doctor when they are sick. An even larger share, 41% said they had difficulties getting advice from their doctor by phone during regular office hours.
  • 6 out of 10 said it was difficult to get care on nights, weekends, or holidays without going to the emergency room.
  • Nearly half of all adults reported at least 1 failure of coordination of care. More than half, 56% of those seeing 3 or more doctors experienced poorly coordinated care.
  • 32% of adults and 40% of those in fair or poor health thought they received either duplicate tests or unnecessary care.

In 2002, the American Association of Pediatrics expanded its definition of a Medical Home Model to include its operational characteristics. “The medical home offers accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective care.” Since then, the American Academy of Family Physicians and the American College of Physicians have developed models referred to as “advanced medical homes” and the “medical home.”  Both entities build upon the AAP model by integrating care coordination features with pay for coordination and performance as outlined in Wagner’s Chronic Care Model described below.

This model identifies the essential components of high quality chronic disease care: the community, the health system, self management support, delivery system design, decision support and clinical information. The goal is healthier patients and more satisfied providers which results in medical cost savings. Enactment of health care reform legislation will accelerate the adoption of the patient centered medical home in the public and private sectors by making key investments in the nation’s primary care infrastructure. The legislation will give the Centers for Medicare & Medicaid Services greater latitude in launching and sustaining innovative models, which may then be implemented by the private sector.

800Seniors.com is a leading referral system in the Elderly Healthcare industry. We are located on 5400 Atlantis Court, Moorpark, California 93021. 800Seniors.com provides the perfect match between seniors searching for health care provisions such as Home Care, Home Health, Skilled Nursing, Hospice Care, Medical Supplies, as well as a variety of Assisted Living Philadelphia and Care Homes nationwide. Take the confusion and hassle out of the search. For more information call 1-800-768-8221, visit http://800seniors.com or fax us your details at (805)517-1623.

About The Author: Gloria Ha’o Schneider is an expert in senior citizen and baby boomer issues. Her topics revolve around Senior Living and Healthcare to provide the latest information to this demographic as well as their families and loved ones.

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