When you are not embedded in the world of healthcare, the terminology can be confusing. As healthcare today is changing so rapidly, new terms are emerging to describe the way providers, clinics and even healthcare networks engage and care for patients. These new terms describe a paradigm of healthcare that is becoming more comprehensive, indicating an expectation that providers look at all the factors involving a person’s health, and support their health beyond isolated or episodic visits.
One such term you may hear is “medical home,” predominantly in relation to primary care. Your primary care provider may be announcing they are a newly certified medical home, or you may hear about a patient’s “medical home” in the context of managing population health.
The full term is actually Patient Centered Medical Home or PCMH for short. A PCMH is really just a model of care more focused on the complete set of factors involving an individual’s overall health, as opposed to simply treating episodes of care.
So, rather than a primary care provider or practice treating an illness such as diabetes, or isolated episode of care such as an ear infection, they create an environment and protocol of more consistent engagement of the patient, ALSO understanding and treating other aspects of a patient’s health outside the clinic environment such as smoking, alcohol consumption, sexual activity, diet and exercise that contribute to an individual’s overall health.
In addition, in order to help the patients make positive progress in such areas, medical home providers may connect patients to outside programs and resources, and assist them in achieving better health outcomes. Then, all the services that might be needed to treat a patient as a whole, are coordinated out of the primary care practice, which acts as the center point of that patient’s medical home, essentially creating a perimeter of care around that patient as needed to improve health outcomes for that individual. The providers actually track that information within a patient’s medical record, and take responsibility for better outcomes overall, not just limited to episodes of care as has traditionally been the practice.
As research has indicated this is a more successful method of treating patients and keeping them well, there are financial incentives in place to reimburse primary care providers that operate as PCMHs. These reimbursements help cover the costs of the additional data tracking, IT infrastructure, staffing and other overhead costs that are entailed in taking on more responsibility for a patient’s overall health, and then reporting those outcomes accurately and consistently as required to maintain PCMH certification.