What if you could have all of your health care needs met through one office?
Take, for example, a possibly broken nose — it’s not so terrible you automatically think Emergency Room, but it’s definitely painful enough to see a doctor. You go to your general practitioner, who refers you to a specialist in another practice. There’s not much to be done but prescribe some painkillers, a script you have to take to yet a third business — the pharmacy – to fill. You’re exhausted. You’re out several co-pays. And your nose still hurts. But what if you could do it all under one roof?
You go for an annual physical, and an in-house nutritionist pops in to help with that cholesterol problem, while a pharmacist fills your prescription, and a care coordinator schedules follow-ups. The paperwork to deal with specialists? Not your job anymore. And if you have a problem after 5 p.m., that’s OK — just call, someone will pick up the phone.
Because these practices offer more preventive care and longer hours, they keep more people out of the ER…
There’s a model for this, known as a patient-centered medical home. And it’s growing. Fast. In 2008 the National Committee for Quality Assurance had certified 28 practices to be patient-centered medical homes. As of March 31, there are 7,118 practices certified to be these one-stop medical shops around the country. They’re concentrated on the coasts, and in the big Western states like Texas. The NCQA has links to accredited practices.
Your insurance company might have a list too. They’re pretty gung-ho about the cost savings the one-stops could provide — so much so that Andy Reynolds, a spokesman for the NCQA, a non-profit that certifies PCMH practices, says many insurers will pay for all the costs related to PCMH certifications. Because these practices offer more preventive care and longer hours, they keep more people out of the ER and (hopefully) head off more serious medical complications before they arise. Think more than $60 billion in medical savings a year.
Not every transition to the new model has gone smoothly thus far. One health care industry journal reports note that patients can fall through the cracks, their care forgotten, as doctors shift file-keeping and patient-tracking systems.
But Americans are likely to see more PCMHs, in part due to the Affordable Care Act.
Under the ACA, offices deemed “health homes” can be eligible to receive extra funds, depend on their state. There are also bonuses for general practitioners who open their office up to treat more Medicare and Medicaid patients — an impetus for the patients and the doctors to create new “health homes” for them as well, especially focused on upping preventative care and lowering emergency visits. It could save the government $175 billion in health care spending by 2020, according to NIH estimates.
It could save the government $175 billion in health care spending by 2020, according to NIH estimates.
And many areas are using guidelines already out there, like those of the NCQA, to determine “health homes” for funding purposes.
So expect to see more of these PCMHs soon, if you haven’t already. Including your own GP.
Why you should care
Because a one-stop shop for all your aches and pains may sound too good to be true — but we might just be getting lucky.