Getting Your Medical Care Home in Order

Dr. Carolyn Clancy, Director of the federal Agency for Health Care Research and Quality (AHRQ), describes the evolving concept of the medical home in this advice column. A medical home takes a team approach to primary care and puts the patient at the center of that team. The idea isn't new, but it’s getting tested in new and larger ways. Medical home teams often work in a primary care doctor’s office or clinic. Team members can include doctors, nurses, pharmacists, and physical therapists. They help coordinate their patients' care across a range of settings, such as health clinics, hospitals, and cardiologists' or other medical specialists' offices. A medical home team also can help coordinate the care that you need beyond primary care. For example, if you have heart disease, you might need to be seen by a heart specialist. The medical home team can arrange for that visit, make sure you're prepared, and see that any test results from the appointment are provided to you and your care team. Some of the largest primary care groups in the United States have agreed on key principles of a patient-centered medical home. They are: the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Osteopathic Association. Starting this summer, the Federal government (PDF File; PDF Help) will launch a 3-year demonstration of the medical home model for Medicare patients testing this care model for older patients with certain illnesses that need ongoing medical monitoring, advising, or treatment. Medical home teams that want to take part in this project must be able to track patients' test results, review medicines, and follow up with providers. The results of the Medicare project will be important as the population ages as people 85 and older are the fastest growing segment of the U.S. population. The 65 and older group is expected to double in size in the next 25 years.