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What Are Patient Centered Medical Homes?

Hardly anybody actually enjoys seeing a doctor.  It’s hard to get an appointment, you have to take off work and juggle other responsibilities, and usually once you get there,Stethoscope you’re parked in the lobby for a good 15-30 minutes. 

When the M.D. finally sees you, she’s usually in a hurry to treat you and get on to the next patient – most doctors schedule at least 24 patients per day.  Since there’s hardly any time to talk, most patients don’t bother to ask their doctors about the small things, like that persistent knot in your shoulder or random ailments.

Another issue with this system is that when a patient is seeing multiple specialists and primary care physicians, there is no one who really has a full picture of his or her needs.  Each doctor is just treating a piece – not the whole person.

A New Innovation in Health Care Delivery: Patient Centered Medical Homes

To respond to the common problems we’ve all felt with this health care delivery model, some industry stakeholders are advocating for a new system: Patient Centered Medical Homes. With a Patient Centered Medical Home, each patient is assigned a personal health care provider that basically acts as the “Account Executive” for their health.  They handle a patient’s primary care, and see far fewer people than the typical doctor would, allowing them more time to discuss things that are often missed like wellness needs, mental health, and minor problems that may indicate an issue down the road.  

When a patient needs to see a specialist, the personal health care provider puts the patient in touch with the necessary doctors and coordinates care throughout the process.  They are always in the loop and are the point person for the team of people working with a patient.  Patient Centered Medical Homes also rely on electronic health records to share information more easily with those involved in a patient’s care.

Although a patient would have to pay slightly more for this kind of care upfront, they would in theory save in the long run by preventing or detecting conditions early, as well benefiting from a higher quality of care overall.

Challenges Facing Patient Centered Medical Homes

Patient Centered Medical Homes sound pretty great, right?  But for a number of reasons, it would take some time for this approach to achieve lift off (if it ever does).  This isn’t how our current health care system works – providers aren’t used to working this way.  It will take a while (and some “guinea pigs”) to start getting doctors, hospitals, and insurance companies comfortable with this kind of approach.

In the Milwaukee area Anthem Blue Cross Blue Shield and West Bend Clinic have partnered to test the concept of Patient Centered Medical Homes in the real world.  We're looking forward to hearing the results of this pilot program (may be a topic for a future blog).

The Need for Innovative Benefits Strategies

Keeping innovative benefits concepts in mind is crucial.  The cost of benefits continues to skyrocket, and with health care reform going into effect over the next several years, a lot hangs in Jeopardy.  Looking for new and creative ideas for managing costs and improving the quality of care is essential, both for the employer to continue to offer value in their benefits package and to reform the health care system to control costs as a whole.

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Topics: HR / Employee Benefits