Every election year we take a serious look at health care and declare that something must be done! It's an emergency and on life support. And yes, it probably is at least in the ICU. But instead of calling a code, let's look at some of the innovative ways providers are rethinking patient care. One of them is called a medical home.
A medical home is an attempt to address the needs of patients who can no longer afford their share of insurance premiums but do not qualify for Medicaid coverage. While designed to improve quality care, especially for the chronically ill, the plans must also be cost conscious to be viable and open doors to those caught between Medicaid and nothing.
A medical home is found in a physician primary care practice with average or above-average quality scores. The care they deliver allows patients to use 15-20% less total payer spending per year than patients being treated regionally by other providers. They operate as a hospital prevention program for their chronically ill patients and take any hospitalization as a personal and organizational failure. They also concentrate on referrals to high quality specialists who provide care sparingly, but appropriately.
Physicians in these practices work as a team with nurses and other care providers to prevent unplanned hospital stays, study the root causes of hospital stays that have occurred and change their practice model to prevent reccurence.
How do they do this?
- First, they demonstrate to the patient and family that they care deeply and personally about their health
- They mobilize family members, social services and other resources required for successful self-management
- They are readily reachable in case the patient senses an impending health crisis
- They go the extra mile to coordinate with ER physicians and hospitals to explore alternatives to hospitalization
Clearly, this model is not the rule in American health care delivery yet. And because if reflects the personality of the individual team members, it's not easy to duplicate. Still, this type of commitment to patient-centeredness is necessary if we're going to tackle the cost beast. Medical schools and graduate schools are already looking at student selection with an eye toward patients first. And retailers such as Nordstrom have shown that selecting employees for high natural service orientation is feasible.
Yes, by all means let's use this opportunity to review the whole health care system, but remember there are those who are trying something now.
Comments