The Medical Home Evolves From Recordkeeping to a Community of Care

By Susan Ladika

Dec. 5, 2012

Patient-centered medical homes might be the newest wave in health care, but the roots of the concept date back to the 1960s.

Initially, the American Academy of Pediatrics defined it has the center for a child’s medical records, according to the U.S. Department of Health and Human Services.

These days, a patient-centered medical home has evolved into a partnership between patients and their primary care physician and other associated health professionals, such as nurse practitioners, counselors and nutritionists, who are actively involved in managing a patient’s health care.

By practicing preventive medicine and working to help manage chronic illnesses, the aim is to cut back on emergency room visits and hospital stays, says Andrew Webber, president and CEO of the National Business Coalition on Health, which represents more than 7,000 employers with 25 million employees and their dependents.

With a medical home, physicians typically receive a small amount per patient, per month (known as PMPM), to help compensate them for managing care. Rather than the existing system, which rewards physicians for seeing a higher number of patients, physicians and their associates are rewarded for coaching, educating and following up with patients, Webber says.

If a patient goes to a specialist, that information is incorporated into his or her medical home records and care.

In 2007, the Joint Principles of the Patient-Centered Medical Home were endorsed by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians and the American Osteopathic Association. Together, the groups represent more than 300,000 physicians.

If an employer is considering offering a medical-home option to employees, Webber says it’s important that the medical home be certified, which “guarantees it has the infrastructure needed to do a better job” providing primary care. One key component is the use of electronic health records.

Another involves naming a point person, such as a nurse or case manager, to work with each patient, Webber says. That point person will have a relationship with the patient and be the point of contact if a health care issue crops up, follow up with the patient, and track the patient’s progress on things such as their diet, lifestyle and use of medication.

As interest in the patient-centered medical home model grows, the biggest challenge may be the limited number of such homes, Webber says. “In so many communities, we don’t have a lot of primary care practices that are certified as medical homes.”

Susan Ladika is a writer based in Tampa, Florida. Comment below or email

Susan Ladika is a writer based in Tampa, Florida.

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