Minnesota Academy of Family Physicians

Minnesota Family Physicians Enthusiastic as Health Care Homes Become a Reality in the State

- Education from the Minnesota Academy of Family Physicians -

August 30, 2010

With the announcement that the first round of Minnesota medical clinics were certified as health care homes by the state, Minnesota family physicians are watching a much-anticipated vision take shape. Health care homes, also referred to as “medical homes,” encompass what family medicine has always been about, but now incorporate a renewed effort to coordinate care for patients and their families with the help of a team of caregivers which includes a primary care doctor such as a family physician, as well as nurses, other specialists, and care coordinators.

On August 17th, the Minnesota Department of Health (MDH) announced that eleven medical clinics have been certified. The Minnesota Academy of Family Physicians (MAFP) would like to offer its congratulations to these organizations and providers, which include MAFP member, Christopher Wenner, M.D., in Cold Spring, four Park Nicollet Health Services clinics in the Twin Cities, and five clinics from Lakewood Health System based in Staples. MAFP member, John Halfen, M.D., was the guiding force behind Lakewood Health System’s transformation. A complete list of certified clinics/providers is available by visiting the MDH website at www.health.state.mn.us/healthreform/homes/certifiedhchs/index.html. MDH’s goal is to certify up to 150 clinics by the end of 2011, and it is expected that many of them will be based in family medicine clinics.

Clinics that have met the standards to become certified will now qualify to receive a monthly per-person care coordination payment from state-subsidized health programs for patients with multiple chronic conditions. Once certified, a clinic may also explore contracting with private insurers to offer care coordination services to their enrollees. Family physicians strongly believe ALL patients would benefit from the services of a health care home, so starting the transformation with patients with complex and chronic conditions is an excellent place to begin.

“We are very excited that health care homes have become a reality in Minnesota,” said Terence Cahill, M.D., a family physician in Blue Earth, and President of the Minnesota Academy of Family Physicians. “This is something family physicians have been trying to make a reality for years because we know it is a way to improve the delivery of health care.”

What is a Medical Home?
A medical home is not an actual building, clinic or hospital, but rather a way of delivering comprehensive health care in a coordinated manner in which the patient’s needs and values are at the center of decision-making. During clinic hours, a care coordinator will help health care home patients schedule appointments, assure test results are reviewed quickly, and connect the patient or family with needed community resources. After hours, patients will know how to reach someone at the clinic who knows their diagnoses, allergies, medications and if they have a detailed care plan. Certified health care homes are required to regularly measure patient satisfaction and quality of care.

“A medical home is based on a continuous relationship with a personal physician,” said Dr. Cahill. “The physician works with a team of health care professionals who together take responsibility for a person’s care from regular check-ups to specialized treatment.” For example, Dr. Cahill explains, a person’s family physician will be aware of the results of every test and every prescription and recommend a treatment plan based on input from specialists and family members. This plan of care will reflect the personal physician knowing the science behind the problem and the personal values of the patient.

What are the Benefits of a Medical Home?
Researcher Barbara Starfield of Johns Hopkins University reviewed dozens of studies, comparing healthcare in the U.S. with other countries and found that adults with a primary care physician rather than a specialist had 33 percent lower costs of care and were 19 percent less likely to die, after adjusting for demographic and health characteristics. Studies have shown that patient-centered medical home interventions for chronic conditions such as asthma and diabetes have reduced ER visits, decreased hospital admissions and readmissions and increased the number of patients receiving optimal care for their conditions. Also the care coordination system encourages timely screening and immunizations.

"Medical homes will allow doctors to spend more time with their patients,” said Dr. Cahill. “Family physicians know that by doing that we can achieve better quality care, higher patient satisfaction and more effective use of resources."