In past generations, it wasn’t unusual for a family doctor to make a house call, perform a broad range of medical services and offer emotional as well as clinical support. While the traditional house call may be a thing of the past, patients today are taking advantage of a return to cooperative hands-on care in the form of patient-centered medical homes, including many in Maryland. Data shows that this care model is not only lowering costs but also improving care.
In a growing number of medical homes, doctors, nurses, care managers and medical assistants work together to help patients manage their care among different facilities, coordinate referrals to specialists and help track health outcomes. Rather than wait until he or she needs emergency care, the patient receives consistent preventative care from a familiar team of practitioners and builds a “long-term healing relationship,” according to the Maryland Health Care Commission.
Medical homes are one of the fastest growing trends in the healthcare industry. In the last six years, the number of certified medical homes nationwide has exploded, from 20 in 2008 to 6,800 today. As of January 2014, Maryland has 58 home health centers, most of which are located in areas with a large number of Medicaid patients, according to Heather DeCarlo, a health IT expert at RxNT in Annapolis.
Thanks in part to funding from the Affordable Care Act, medical home practitioners are now assisted by new forms of information technology, including electronic medical records. The ACA has also fundamentally changed how the country pays for healthcare, DeCarlo said.
Medical facilities are moving away from fee-for-service payments, which encourage more and oftentimes unnecessary medical procedures, to models that encourage cost efficiencies and improved medical outcomes, according to DeCarlo. The ACA incentivizes providers who can prove that they are bringing more services under the healthcare umbrella, like patient education and care coordination, and medical homes support this new team-based model, she said.
State officials have already found promising results among Maryland medical homes.
In 2011, through the MHCC, the Maryland Multi-Payer Patient Centered Medical Home Program began a three-year pilot study to test the medical homes care model. The study included 53 primary and multi-specialty practices throughout the State.
By the second year of the study, nearly half of the practices generated savings and overall care quality increased by approximately 10 percent, according to the MHCC.
CareFirst Blue Cross Blue Shield, Maryland is one of the State’s success stories. Through the use of medical homes, patients’ overall health care costs have been reduced by 4 percent, leading to an estimated cost savings of $40 million in 2011, according to the MHCC.
The MHCC concluded, “Physicians who practice in medical homes anecdotally report much greater satisfaction with their work than in a traditional practice; and investing in comprehensive medical home care has improved quality and reduced total cost to the system because of better care and coordination.”