Medical Home: Team-Based Health Care Delivery Model

Introduction
The medical home is a team based health care delivery model led by a physician or nurse practitioner that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. It is an approach to providing comprehensive primary care for children, youth and adults. Several key foci are important in understanding the overall concept of the medical home. First, the concept of the medical home dates back to the 1960’s and has evolved since its inception. Second, the model of care delivery is concerted effort that requires several key elements. Finally, the new health reform law will give states the opportunity to expand upon current medical home efforts. History of the Medical
Over time, the concept was redefined as it evolved to reflect the changing needs and perspectives in health care. Efforts by Dr. Calvin C. J. Sia, a Honolulu-based pediatrician, to pursue new approaches to improve early childhood development in Hawaii in the 1980’s laid the groundwork for an Academy policy statement in 1992 that defined a medical home largely the way Sia conceived it: a strategy for delivering the family-centered, comprehensive, continuous and coordinated care that all infants and children deserve (Wikipedia, n.d. para. 2). In 2002, the Future of Family Medicine project was created to change and rejuvenate the specialty of family medicine. According to project recommendations, every American should have a personal medical home enabling access to acute, chronic and preventive services. These services should be “accessible, accountable, comprehensive, integrated, patient-centered, safe, scientifically valid, and satisfying to both patients and their physicians” (Wikipedia, n.d. para. 3). A study estimated that if the recommendations from the Future of Family Medicine were followed, health care costs would likely decrease by 5.6%, resulting in national savings of 67 billion dollars per year, with an improvement in the overall
Studies have shown that the medical home model’s attention to the whole-person and integration of all aspects of health care offer potential to improve physical health, behavioral health, access to community-based social services and management of chronic conditions (NCSL, 2012, para. 3). The model is designed around patient needs and aims to improve access to care (e.g. through extended office hours and increased communication between providers and patients via email and telephone), increase care coordination and enhance overall quality, while simultaneously reducing costs. Paramount to medical home care is health information technology (HIT) and payment reform (NCSL, 2012, para. 6). Because the medical home can be a physical or a virtual network of providers and services, HIT facilitates communication and information sharing among providers. For example, medical homes use electronic health records, which give providers instant access to patient information regardless of location. ACA’s Impact Health care reform has created new possibilities for the advancement of medical home. The new health reform law will give states the opportunity to expand upon current medical home efforts. It is critical that states create medical home programs that meet the needs of children and pediatricians, including