Patient care: Detroit employers: use your collective power to open the door to the patient-centered medical home.

Author:Matuszewsk, Ewa

In a new era where change is the mantra, it's important to incorporate meaningful and timely change into the discussion as it relates to health care. While staggering health care costs and insurance premiums are pressing issues on almost any employer's agenda, let's steer the discussion in a new direction and consider the power that employer groups actually have in setting healthcare policy and indeed in transforming our healthcare system as we know it. I'm specifically referring to a health care movement called the patient-centered medical home (PCMH). Throughout the country, and with Michigan leading the way in certain sectors, medical associations, physician leaders and prominent employers are gearing up for a major transformation in the way patient care is handled - and paid for - at the primary care level.

First, some background on the patient-centered medical home. The PCMH is a health care approach that facilitates partnerships between individual patients, their personal physicians and the patient's family and is guided by joint principles agreed upon by the American Medical Association, American Academy of Family Physicians, American Academy of Pediatrics, and other prominent medical associations. The PCMH joint principles include the following:


Personal physician Each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care.

Physician directed medical practice The personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients.

Whole person orientation The personal physician is responsible for providing for all the patient's health care needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care for all stages of life; acute care; chronic care; preventive services; and end of life care.

Care is coordinated and/or integrated across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient's community (e.g., family, public and private community-based services). Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.

Quality and safety are hallmarks...

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