Can the Medical Home Survive Long-Term?
I very much respect my primary care physician and her advice on my health does make an impact on my actions. Once I told her that my knees were hurting a bit and I asked her what I should do. She took out a note pad and scribbled on it and handed me the paper. On it, in big bold letters she had written, “EXERCISE.” I laughed. She then added that if I lost just 10 pounds she could promise me the pain would disappear completely. I took the message to heart and followed her recommendation; she was right.
I don’t bring this up because I think hospitals or health system should open weight loss clinics—although my colleague recently wrote an interesting column on this topic. I recount this story, as part two of my look at the patient-centered medical home. These days, what my doctor did, now nearly eight years ago, is still somewhat out of the norm.
In a fee-for-service reimbursement environment, it isn’t beneficial for me to get well, or in this case fit—especially if I do it without the help of my healthcare provider. However, in the coming years, how you are reimbursed will change and you will be penalized if your patients’ health continues to decline—especially those with chronic health issues. Right now, medical homes nationwide are gathering data to see if their work will help reduce readmission rates.
Although it makes logical sense that by maintaining the health of chronic care patients they will have fewer trips to the hospital, as of yet there is no hard data supporting it. Watch for that information in the next year or two though. Last week we looked at how one program had created a sort of self-sustaining version of a medical home by keeping the same number of staff and increasing preventive care. But is that approach possible in all circumstances? It’s a question healthcare leaders are exploring through pilot programs in nearly every state as they try to determine the best way to run a medical home.
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