Overview of the Medical Home
The American Academy of Pediatrics (AAP) describes the medical home simply as a “place where everybody knows your name and your medical records are complete” (2018). It is not a building or a single place because it is bigger than the four walls of a primary care medical practice. It includes families, specialists and subspecialists, and community resources. It emphasizes and promotes those partnerships on behalf of each patient so no one will fall through the cracks and all will receive quality care.
A patient-centered medical home encircles the patient and engages the health-care team to create a personalized plan for reaching health goals (Primary Care Collaborative, n.d.). “Patient-centered care is considered to be care that is relationship-based and makes the patient feel known, respected, involved, engaged, and knowledgeable” (U.S. Department of Health and Human Services [HHS], 2016).
A patient-centered medical home is:
- Accessible
- Family-centered
- Compassionate
- Comprehensive
- Continuous
- Coordinated
- Culturally effective
It features:
- Comprehensive primary care delivery
- Care coordination across multiple services and settings
- Teamwork among staff, all of whom work to their highest abilities
Studies show that medical homes providing patient-centered care are linked to “positive outcomes, including improved physician-patient communication and relationships, higher patient satisfaction, better recall of information and treatment adherence, better recovery, and improved health outcomes” (HHS, 2016). Medical homes also offer increased practice efficiency and productivity and help reduce costs.
Texas Health Steps endorses and promotes the medical home as a way to provide consistent, coordinated health care for children and adolescents ages birth through 20 years who are enrolled in Medicaid. Texas Health Steps encourages all preventive medical checkups to occur in the medical home as part of patient-centered health care.
The ability to provide patient-centered care in the medical home takes effort and persistence. Perceived challenges may include:
- Insufficient personnel
- Increased workload
- Lack of communication skills and tools to support care coordination
- Limited availability of community resources for referrals
- Lack of referral relationships with clinicians who are experienced in care coordination
Populations at Risk of Poor Care Coordination
Research shows that certain populations experience gaps in effective care coordination (Pediatrics, 2016):
- Black children
- Hispanic/Latino children
- Children in immigrant families
- Children with special health-care needs
Improving primary care through the medical home is imperative for these children. “Educating parents about their child’s needs and assisting them with access to needed resources are important first steps that providers can currently take in addressing the disparities in receiving family-centered care and care coordination” (Ibid.).