What we’re learning about the benefits of having one home for all the care you need.
About half the children in Kansas are homeless. It’s not that they don’t have a home, although far too many don’t. They don’t have a medical home. They are living their lives without a relationship with a primary provider who knows them and their health well enough to provide continuing care.
Their families probably have no insurance or sufficient means to pay for their care when they need it. Of course, there’s no insurance and then there’s insurance that costs a lot and pays for very little. A lot of these “homeless” children have an access problem despite being covered simply because their insurance isn’t good enough.
Some of these families rely on visits to a hospital emergency room or urgent care clinics, but only when it’s clear they must have care.
“The problem with these solutions lies in both the cost and the quality of care received,” said Dr. Regan DeHart, Family Medicine physician from GraceMed’s Helen Galloway Clinic. “Urgent care clinics have to staff for the unexpected, so their overhead is generally higher than a primary provider. And, of course, going to an ER is substantially more expensive than that. Then there’s the difference in the kind of care you get. Emergency and urgent care is focused on an illness or injury. Primary care is focused on the ongoing health of the patient.”
A team built around the need of each patient
That point about being “patient focused” is actually important enough to be reflected in the full name of a medical home, as in Patient Centered Medical Home (PCMH). The National Committee for Quality Assurance is the most widely accepted program for certifying PCMH practices using a defined set of standards. PCMH is a relatively new way of delivering care that puts the individual patient’s needs at the forefront of everything the provider does, including rallying the resources of others, specialized providers to provide more coordinated, complete service.
“So much of what we can do for a patient comes from developing and knowing that patient’s medical history,” Dr. DeHart explained. “That’s information that is maintained at their primary care clinic. Over time, your health will obviously evolve and conditions can often arise that a provider who knows your history can identify early. If other resources are needed, that’s where being a patient with a medical home can really be beneficial.”
Complete care, complete collaboration
That’s because another characteristic of a PCMH, like GraceMed, is the clinic’s ability to provide a full range of health services. At GraceMed that included dental, vision, behavioral health and now, for the benefit of our growing diabetic population, even podiatry.
There are many situations in which a primary provider might see a patient for a medical condition, but identify symptoms that suggest the need to involve other specialists. The presence of gum disease in a dental patient may raise concerns about the potential for heart attack or stroke. Headaches can sometimes indicate a vision problem. And the connections between disorders like depression and chronic disease often require medical providers to refer to behavioral health consultants or vice versa. Any of these conditions left untreated can have serious consequences. Nowhere is this more apparent than in the meteoric rise of diabetes.
Diabetes is the quicksand of diagnoses. Once you have it, only the most diligent management of diet and other lifestyle factors can keep you from the eventual grasp of conditions like heart disease, severe vision impairment or renal failure. Studies have shown that care delivered through a PCMH model actually improves test outcomes across several diabetes metrics. But it also takes one other important factor: a patient who is fully engaged in understanding and fulfilling his or her responsibilities as a member of that team.
Making the patient a partner
And that brings us to the last characteristic of a medical home: patients who are actively involved in their own care. “It’s so important that we as providers build relationships with our patients,” Dr. DeHart noted. “But it’s just as important that we encourage patients to ask questions, keep us informed about their health, get check ups and make the lifestyle changes that will really make a difference in the quality of their life and health. When you have a medical home, you’re encouraged to play that more active role.”
The idea of a medical home is new enough that it’s not widely understood or appreciated. At GraceMed, we’re trying to get the word out through a new advertising campaign. On TV, radio, digital billboards and newspaper ads, we’re telling the communities we serve that having a medical home like GraceMed is important to the continuing quality of your health.
No place like home in a pandemic
That’s even more true now that the coronavirus has disrupted all of our lives. The pandemic has made a bad thing worse as even more of us have been essentially avoiding doctors like the plague. Some of that is related to the loss of employers’ insurance; some reflects a fear of exposure to the virus.
The truth is that having a medical home in times like these is like having a port in the storm. At GraceMed, for example, we’ve established COVID-19 procedures that significantly reduce the risk of exposure to the virus. So you can maintain your overall health in a more protected environment with the providers who know you best and steer clear of emergency care settings where the potential for exposure can be higher.
Home is where your trust is. Ultimately, the secret sauce that makes a medical home work is trust – between you and your provider as well as the members of the team managing your care. “Patients have reported that they have a better experience in a medical home environment,” Dr. DeHart added. “I think that’s because they know they are being cared for and not just treated.”
This content was featured in our State of Grace quarterly news magazine. If you would like to receive the State of Grace at your home or your inbox, please let us know by completing the form on this page.