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Dominick Zampino, DO, named AtlantiCare medical director of Academic Affairs
For Immediate Release: February 12, 2013
The medical home is a relatively new healthcare delivery model that is being rapidly adopted throughout the nation. It is a team-based, coordinated outpatient care approach that is accessible and affordable and contributes to higher quality patient care.
More than 25 primary care practices in the area have adopted AtlantiCare’s Primary Care Plus model of care, which features timely appointments, electronic medical records, and a commitment to connecting and coordinating everyone involved in a patient’s care.
What is a Medical Home?
Over the past several years, multiple groups—healthcare organizations, regulatory agencies, insurance providers, the government and others—have collaborated to define what a medical home is. The model they developed is similar in many ways to a primary healthcare office, but medical homes offer much more and are specifically focused on how best to efficiently and effectively care for patients.
“Each medical home strives to meet four important goals: to be patient-centered; to integrate electronic medical records into the practice and leverage other technology; to measure quality and strive for better outcomes; and to make efficient use of healthcare dollars,” says Terri Schieder, RN, MS, MBA, vice president for Clinical Integration, AtlantiCare.
One goal of the medical home is for it to be “patient-centered,” and although healthcare professionals at AtlantiCare have always put a priority on patient care, medical homes are more intentionally focused on a patient’s overall care experience, satisfaction and outcomes.
Mitchell Kaminski, MD, medical director, AtlantiCare Physician Group Primary Care and Medical Specialties, explains one way this can play out in a medical home.
“When a sick person calls in for an appointment, she shouldn’t be asked, ‘How sick are you feeling?’ to determine when she will be seen,” he says. “The patient should be able to get the access to care she needs when she feels she needs it. If a person with diabetes needs to meet with his healthcare team, he should be able to come in at a time that doesn’t conflict with his work schedule.”
Patients aren’t the only ones who benefit from the medical home model. Overall healthcare costs are also reduced. For instance, one of the most costly diseases to manage is diabetes. Christeen Cornell, RN.BSN, CCM, director of Clinical Transformation, AtlantiCare, gives an example of how a medical home can not only help a diabetes patient, but help contain costs.
“There is a tremendous amount of care coordination involved with patients who have diabetes," says Cornell. “People with diabetes often need to see multiple specialists, and have tests and preventive procedures. In the medical home model, our nurse care managers help coordinate their care. Our goal is to manage care in a proactive manner so patients get the necessary preventive care. Ultimately, this means they go to the hospital less often and have fewer complications, which also means fewer healthcare dollars are spent caring for that person.”
Robust technology is key to achieving these goals. Just 20 years ago electronic medical technology was not advanced enough to support the goals of today’s medical home.
Medical homes are expected to rely on electronic medical records (EMRs), but also leverage other technology in order to deliver the highest quality care most affordably. AtlantiCare uses this technology to enhance communication among caregivers and with the patient. For example, in addition to recording and storing information about a patient’s health in an EMR, AtlantiCare Physician Group Primary Care Plus uses technology to send patients reminders about preventive care and testing. If patients prefer, AtlantiCare Physician Group emails them test result. AtlantiCare is also piloting a patient portal through which APG Primary Care Plus patients can communicate electronically with their physician’s office, request appointments and referrals, and request refills of prescription medications.
“Also, when medical home physicians work with specialists, they can text them—although physicians cannot text confidential patient information, they can text to ask each other questions or quickly schedule tests. Using technology resources makes physicians more effective, prevents costly duplicative and results in better patient care,” says Kaminski.
Measuring Quality and Improving
AtlantiCare is in the process of acquiring the National Committee for Quality Assurance (NCQA) Primary Care Medical Home (PCMH) recognition for all of its primary care practices. To attain this designation, a practice must meet or exceed the NCQA’s standards for organizing care around patients, working in teams and coordinating and tracking care over time.
“AtlantiCare has always measured patient satisfaction and worked to improve quality,” says Schieder. “However, now we are focusing on ‘customer experience’ – which includes ensuring patients have quality care that we deliver efficiently and effectively. We now engage our patients as customers and gather more information from them about their care experience so we can serve them even better.”
Making Efficient Use of Healthcare Dollars
The final mandate for a medical home is that it makes good use of healthcare dollars, and the design of the medical home supports this goal.
“Care that is most costly is often due to lack of coordination,” explains Schieder. “At medical homes, the care is highly coordinated, and staff gets very familiar with their patients and their unique health issues. They can then better determine if a patient really needs more expensive specialty care, or if some tests or procedures might not even be needed.”
In addition to nurse care managers who play an important role in the medical home model, medical assistants and front-end staff are more closely involved in communicating with the patient.
“Front-end staff provide appointment summaries to patients and review them,” says Cornell. “In addition, if a patient goes to an emergency department or is hospitalized, the nurse care manager communicates with hospital team caring for the patient and shares that information with the primary care team. The nurse care manager ensures that person has a timely follow up appointment at the medical home after release from the hospital.”
Medical homes also help reduce healthcare costs because they treat patients before their health issues escalate into bigger problems. So, instead of incurring a costly emergency department visit, or hospital stay, a medical home can help patients avoid those visits by providing the preventive care they need earlier on in the care cycle.
The decision for a primary care center to become a medical home is not only the best for choice for patients and providers, Kaminski says it also the only sustainable model.
“Establishing medical homes will allow healthcare to evolve—it will be less ‘put out the fire’ care with people going to an emergency department for a problem that could have been prevented. Instead, people will be healthier—and we will have a healthier system. Some health systems are not yet moving in this direction, but it is not only the best direction, I believe it is the only sustainable one.”
For More Information
To schedule an appointment with an AtlantiCare Primary Care Plus provider, or for information about other AtlantiCare programs and services, call the AtlantiCare Access Center at 1-888-569-1000, visit www.atlanticare.org or find AtlantiCare on Facebook at www.facebook.com/AtlantiCare.
AtlantiCare is a regional healthcare organization based in Egg Harbor Township, New Jersey, whose more than 5,000 employees serve the healthcare needs of the community at more than 60 locations. A 2009 Malcolm Baldrige National Quality Award winner, AtlantiCare includes AtlantiCare Regional Medical Center (ARMC), the AtlantiCare Foundation, AtlantiCare Health Plans, AtlantiCare Behavioral Health and AtlantiCare Health Services. ARMC became the 105th hospital in the nation to attain status as a Magnet™ designated hospital in March of 2004 and was redesignated a Magnet™ hospital in 2008.