Person-Centered Healthcare Homes
Frequently recommended in healthcare reform, the Patient-Centered Medical Home is a team-based clinical approach that includes the consumer, his or her providers, and family members, when appropriate. This approach centralizes care management and supports individuals as they work toward self-management goals.
Care management is central to the Medical Home’s recent shift away from focus on episodic acute care to focus on health management of defined populations, especially those living with chronic health conditions. This shift in focus has also led to national dialog that includes lessons learned from primary and behavioral health integration efforts. In fact, many now propose renaming this clinical approach “Person-Centered Healthcare Home,” recognizing the importance of caring for the whole person. Such a shift would necessitate integrating primary and behavioral healthcare and, as seen in the IMPACT model, explicitly building care manager/behavioral health consultant and consulting psychiatrist functions into the Medical Home model.
This emerging “Health Home” concept is an innovate approach to healthcare service delivery that promises better patient experience and better results than traditional care. While it has many characteristics of the Patient-Centered Medical Home, the Health Home can be customized to meet the specific needs of low-income patients with chronic medical conditions.
The Health Home is the next step in improving on the Patient-Centered Medical Home.
Federal and State Policy
The Integrated Care Resource Center (ICRC) is a national initiative of the Centers for Medicare & Medicaid Services to help states improve the quality and cost-effectiveness of care for Medicaid’s high-need, high-cost beneficiaries. View their health homes fact sheet, and their state health home resources.
New York State has received approval on its health home State Plan Amendment, making it among one of the first in the nation. The state has posted its amendment, rate information, provider qualifications, a more. In addition, webinar slides.
The Affordable Care Act authorized a health home provision [Sec. 2703 & Sec. 19459(e)] that enables states to build a person-centered care system to improve outcomes for beneficiaries and ensure better services and value for state Medicaid and other programs, including mental health and substance abuse agencies. SAMHSA's Health Homes webpage houses a host of information, including state guidance on ACA Sec. 2703 (the health home provision) for people with behavioral health disorders.
Missouri was the first state to submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services, and it is the first state to receive approval. The Missouri Department of Mental Health makes many of their resources available online.”
Resources
AHRQ’s Early Evidence on the Patient-Centered Medical Home, released in February 2012, looks at more than 480 practices, and provides a table summarizing findings on pages 9-10.
The National Council for Community Behavioral Health Care developed Behavioral Health/Primary Care Integration and The Person-Centered Healthcare Home, a report that assesses the need and importance of Health Homes, models, and policies that affect the implementation and sustainability of Health Homes. The Care Models for Persons with Chronic Substance Use video also discusses the National Council report.
The National Association of Community Health Centers Magazine published the article “The Evolution of the Primary Care Medical Home”, authored by NACHC’s David Stevens MD, FAAFM, to provide health centers with background and guidance on implementing Medical and Health Homes.
The Patient-Centered Primary Care Collaborative (PCPCC) aims to improve the American healthcare system by facilitating improvements in patient-physician relations and creating a more effective and efficient healthcare delivery model. To achieve these goals, the PCPCC has become a major developer and advocate of the patient-centered medical home model.
Introduction to the Patient-Centered Medical Home is a multimedia program developed to explain this model of healthcare to consumers. The program is the result of collaboration between the PCPCC and Emmi Solutions.
NCQA’s Patient-Centered Medical Home 2011 is an innovative program for improving primary care. In a set of standards that describe clear and specific criteria, the program gives practices information about organizing care around patients, working in teams, and coordinating and tracking care over time. The NCQA Patient-Centered Medical Home standards strengthen and add to the issues addressed by NCQA’s original program.
The Joint Principles of the Patient-Centered Medical Home were developed by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association to describe the characteristics of the Patient-Centered Medical Home.
Webinars
CIHS hosted a Person-Centered Health Homes Webinar on May 16, 2011. Presents Chuck Ingoglia and Larry Fricks discuss the “Making of a Person-Centered Health Home.”