Medical Homes are becoming an increasingly important component in the race to “fix” our healthcare system.

A 2004 study published in the Annals of Family Medicine estimated that if every American had a Medical Home, healthcare costs would likely decrease by 5.6%, resulting in national savings of $67 billion per year, with an improvement in the quality of the healthcare provided.

The National Committee for Quality Assurance (NCQA) partnered with the American College of Physicians (ACP), American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP) and American Osteopathic Association (AOA) to develop the Physician Practice Connections® - Patient-Centered Medical Home™ program to provide recognition to physician practices dedicated to the Medical Home approach.

The Physician Practice Connections® - Patient-Centered Medical Home™ program defines seven principles that comprise the Medical Home:

Personal physician

Each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care.

Physician-directed medical practice

The personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients.

Whole person orientation

The personal physician is responsible for providing for all of the patient’s healthcare needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care for all stages of life; acute care; chronic care; preventive services and end of life care.

Care is coordinated or integrated

Care is coordinated or integrated across all elements of the complex healthcare system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient’s community (e.g., family, public and private community-based services). Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it, in a culturally and linguistically appropriate manner.

Quality and safety

Quality and safety are hallmarks of the Medical Home.

• Practices advocate for their patients to support the attainment of optimal, patient-centered outcomes that are defined by a care planning process driven by a compassionate, robust partnership between physicians, patients and the patient’s family.
• Evidence-based medicine and clinical decision-support tools guide decision making.
• Physicians in the practice accept accountability for continuous quality improvement through voluntary engagement in performance measurement and improvement.
• Patients actively participate in decision making and feedback is sought to ensure patients’ expectations are being met.
• Information technology (IT) is utilized appropriately to support optimal patient care, performance measurement, patient education and enhanced communication.
• Practices go through a voluntary recognition process by an appropriate non-governmental entity to demonstrate that they have the capabilities to provide patient-centered services consistent with the Medical Home model.
• Patients and families participate in quality improvement activities at the practice level.

Enhanced access

Enhanced access to care is available through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician and practice staff.

Payment

Payment appropriately recognizes the added value provided to patients who have a patient-centered Medical Home. While aspiring to improve patient care, the four primary care groups envision implementation of the PCMH as linked to more rational (and higher) payment for primary care, which is in very fragile status in the U.S. The four primary care groups, aided by others, have held discussions with employers, health plans and the federal government to encourage the development of PCMH implementation/demonstration programs. In concert with the joint principles, the PPC-PCMH standards emphasize the use of systematic, patient-centered, coordinated care management processes.

A Google search of the term “Medical Home” produces close to 800,000 hits. And leading organizations in industry and government are beginning to require healthcare providers to support aspects of the Medical Home for participation in demonstration, pilot and other health management programs.

Like the Pharos Solution, the Medical Home was developed in response to the need for better healthcare value — better quality care for less cost. The Medical Home approach shifts the medical model from an episodic, acute care focus to proactive, continuous care.

Pharos supports the Medical Home by offering an easily accessible, easy-to-use solution that increases and personalizes care coordination, allows care access from remote locations between physician visits, facilitates a team approach to care coordination and emphasizes quality and safety.