People frequently receive healthcare services from different systems and multiple providers without the benefit of effective communication and coordination of care between systems. As a result, health care is complex and confusing, fragmented, less effective than is ideal, and more costly.

Primary care physicians are frustrated by the systematic undervaluing and undermining of the relationship patients have with their personal physician—the single most important factor in determining the quality of care they receive and how much it costs. They're also frustrated by a payment system that rewards doctors for increasing the volume of visits and procedures, but that will not reimburse them for providing preventive services, controlling common chronic disease, or for the work involved in coordinating care that takes place outside of a traditional office visit.

What is a Medical Home?

Medical Home is a model of delivering healthcare that is accessible, continuous, comprehensive, patient-centered, coordinated and compassionate. Medical Home looks at maintaining a personal and coordinated approach to care. A physician leads a team of professionals who take responsibility for treating and managing care of the whole person. If someone has multiple illnesses and conditions, it is an approach that coordinates care within the primary care office, but also within the referral network.

What was the goal of the team?

The goal of the team was to determine if the Medical Home concept would be viable in central Illinois. The team looked at:

• Identifying the components of a medical home using the National Committee for Quality Assurance Physician Practice Connections (PPC) Standards
• Recommending measures to assess the capability and extent of delivery of continuous, coordinated patient-centered care
• Identifying and prioritizing missing functionality in provider practices
• Developing a process redesign guide for provider practices
• Preparing a cost analysis of the medical home—development costs to implement and ongoing costs to maintain
• Developing new incentive options, both financial and non-financial, that stimulate development of medical home capabilities

What about changing the payment structure to support this model?

The team is looking at the payment structure, seeking different ways to enhance the reimbursement to primary care offices to cover the increased costs of starting a Medical Home. There will certainly be a continuation of some "fee for service," but in addition, there will have to be additional funding to cover start-up costs of a Medical Home, both for increased staffing and new infrastructure, such as an electronic medical record.

How will the Medical Home benefit the healthcare system?

The Medical Home model is expected to improve healthcare outcomes and efficiency in office practice. Supporters of the model believe there will be a reduction in costs because there will be better management of chronic care. Statistically, chronic care costs account for 70 percent of the total care costs for many people.

Medical Home Team

Team Lead: Dean Gravlin, MD
Black Belt: Anoop Mahajan

Team Members:
Jim Adams, MD
Sharon Adams, MBA
Charlie Barton
Connie Bridges
Lori Brown, RN
Melinda Cooling
Judy Ellis, RN
Shari Erickson
Steve Hippler, MD
John Houser, MD
Nicole Ingold
Michael Johnson, MD
Kurt Keller
Jana Keyes, RN
Rick Luetkemeyer, MD
Diana Scott
Robert Scully, MD
Shelley Shallat, MD
Robin Spencer, MD
Gregg Stoner, MD
Ralph Velazquez, MD
David Wellman, PhD
Tom West
Michael Zia, MD