Medical Home’ Concept Improves Care, Controls Costs

WASHINGTON — Would­n’t it be fan­tas­tic to get the old-fash­ioned kind of health care, in which the doc­tor knew you and your fam­i­ly and kept track of your med­ical con­di­tion, but with the addi­tion­al con­ve­nience and access to health care infor­ma­tion that mod­ern tech­nol­o­gy pro­vides?

That’s exact­ly what the TRICARE health insur­ance pro­gram is striv­ing to pro­vide as it rolls out the new patient-cen­tered “med­ical home” con­cept to an increas­ing num­ber of its ben­e­fi­cia­ries, Navy Rear Adm. (Dr.) Chris­tine S. Hunter, the top TRICARE offi­cer, told Amer­i­can Forces Press Ser­vice.

Civil­ian med­i­cine has embraced the med­ical home con­cept, which intro­duces a team approach to health care and estab­lish­es a con­sis­tent, long-term rela­tion­ship between patients and a provider team, Hunter explained.

The TRICARE Man­age­ment Activ­i­ty began intro­duc­ing the con­cept last year. Already, 655,000 of its 9.5 mil­lion ben­e­fi­cia­ries are enrolled in the med­ical home con­cept. Hunter’s goal is to increase that num­ber to 2 mil­lion by the end of 2011. With­in the next sev­er­al years, she said, she hopes to see as many as 3 mil­lion ben­e­fi­cia­ries in enrolled in the con­cept. The Air Force was the first ser­vice to begin intro­duc­ing the con­cept through its Fam­i­ly Health Ini­tia­tive. The Navy fol­lowed with its Med­ical Home Port. The Army fol­lowed with its Army Home for Health pro­gram, which focused ini­tial­ly on wound­ed war­riors but now has expand­ed.

In addi­tion, 750 TRICARE net­work providers are now cer­ti­fied as med­ical homes.

In some cas­es, par­tic­i­pa­tion is vol­un­tary, with facil­i­ties offer­ing ben­e­fi­cia­ries the option to join as med­ical home teams are stood up. In oth­er cas­es, entire sites have trans­formed into med­ical homes, with all of their ben­e­fi­cia­ries assigned to med­ical care teams.

Regard­less of how the con­cept is intro­duced, Hunter called it a win-win sit­u­a­tion for every­one involved. Patients are assigned to a med­ical home team that typ­i­cal­ly con­sists of a doc­tor, a physician’s assis­tant, a nurse and med­ical tech­ni­cians. Togeth­er, they part­ner with the patient to sup­port a com­pre­hen­sive health care plan, Hunter said.

This improves the patient expe­ri­ence, she added, by fix­ing what many ben­e­fi­cia­ries call a short­com­ing of TRICARE as well as many oth­er health care pro­grams: nev­er see­ing the same health care provider twice.

That too often put patients in the posi­tion of hav­ing to explain and re-explain the same issue or con­cerns to every new doc­tor, Hunter said. As a result, she explained, they were like­ly to focus only on imme­di­ate con­cerns –- what brought them into the doctor’s office –- instead of long-term health main­te­nance and well­ness goals. Under the med­ical home con­cept, every mem­ber of the provider team has access to the beneficiary’s med­ical records, and works col­lab­o­ra­tive­ly with the rest of the team to pro­vide the best care pos­si­ble, she said.

When patients vis­it a hos­pi­tal or clin­ic or call in with a ques­tion or con­cern, they see or talk to a mem­ber of that team –- not anoth­er health care provider who steps in because the patient’s provider is unavail­able. And if the patient needs to be referred to a spe­cial­ist, the team makes the refer­ral and tracks the results. Ulti­mate­ly, the patient receives bet­ter, com­pre­hen­sive care and a bet­ter over­all health care expe­ri­ence, Hunter said.

And because the med­ical home con­cept puts heavy empha­sis on pre­ven­tive med­i­cine, it helps to address prob­lems before they esca­late, Hunter added. Not only does this make ben­e­fi­cia­ries health­i­er, she said, it also reduces the need for cat­a­stroph­ic and expen­sive med­ical inter­ven­tion.

Mean­while, the patient-cen­tered med­ical home con­cept takes advan­tage of new elec­tron­ic tools to fur­ther improve com­mu­ni­ca­tion between patients and their health care teams. Patients can use these tech­nolo­gies to sched­ule appoint­ments, get pre­scrip­tion refills or have health care ques­tions answered. And if they need to con­tact a health care provider after nor­mal duty hours, they can do so vir­tu­al­ly. That reduces the like­li­hood that they’ll report to the emer­gency room because they don’t know where else to go, Hunter said.

The health care team, in turn, can use these tech­nolo­gies to remind patients when it’s time for a check­up, test or inoc­u­la­tion or to deliv­er lab results and explain what they mean. They also can use them to pro­vide infor­ma­tion and coach­ing to ben­e­fi­cia­ries work­ing to lose weight, quit smok­ing or achieve oth­er longer-term health main­te­nance or well­ness goals. Ulti­mate­ly, Hunter said, the med­ical home con­cept sup­ports what she calls TRICARE’s “quadru­ple aim.” “We want to have readi­ness for the mil­i­tary mem­bers and their fam­i­lies, and we want to do that through the best pos­si­ble health [for ben­e­fi­cia­ries] and enhance the patient expe­ri­ence,” she said. “And then we want to do so at a respon­si­ble cost.” Cost con­sid­er­a­tions make the con­cept par­tic­u­lar­ly attrac­tive as Defense Sec­re­tary Robert M. Gates seeks ways to con­trol health care costs that are eat­ing away an ever-increas­ing per­cent­age of the Defense Depart­ment bud­get.

But Hunter said the best part of the patient-cen­tered med­ical home con­cept is that it puts ben­e­fi­cia­ries’ inter­ests first. “You are get­ting qual­i­ty, you are get­ting a good patient expe­ri­ence, and then the cost [of deliv­er­ing health care] will nat­u­ral­ly fol­low,” she said. “If patients are healthy, the cost is low. … So if you do the right thing for the patient and then we get to health, cost will fol­low.”

Source:
U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)

More news and arti­cles can be found on Face­book and Twit­ter.

Fol­low GlobalDefence.net on Face­book and/or on Twit­ter

Team GlobDef

Team GlobDef

Seit 2001 ist GlobalDefence.net im Internet unterwegs, um mit eigenen Analysen, interessanten Kooperationen und umfassenden Informationen für einen spannenden Überblick der Weltlage zu sorgen. GlobalDefenc.net war dabei die erste deutschsprachige Internetseite, die mit dem Schwerpunkt Sicherheitspolitik außerhalb von Hochschulen oder Instituten aufgetreten ist.

Alle Beiträge ansehen von Team GlobDef →