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Obamacare 101: Medical Home One-Stop-Shop For Health Care

For years, this 6,000 square foot building was an Albertson’s grocery store. Now, Fort Worth-based JPS Health Network is giving it a makeover. In 2015, people won’t come to this strip mall to shop for bread or bananas, but instead for health care.

“You’ll see waiting rooms and labs and exam rooms and procedures just like you would in any other health facility,” Scott Rule, says. Rule is chief risk officer forJPSHealth Network. He says strip malls made shopping more convenient, and cheaper. Why can’t it do the same for health care?

The Medical Home Model

Having a facility where you can check in with your primary care doctor, get multiple exams, pick up your prescriptions and even visit the dentist, is part of a growing trend known as the patient centered medical home.

Every medical home is different, but the overarching goal of the patient-centered medical home(PCMH) is the same: cut health care costs and improve quality by beefing up access to primary care.

Right now, JPS has more than a dozen primary care sites scattered across Tarrant County.Dianna Prachyl, JPS vice president of community health, says JPS is transitioning all of them to the medical home model, and moving four of them to the former Albertson’s at the strip mall.

“We believe it will improve patient care and consolidate services,” she says.

Making it easier for patients to see the doctor is one part of strategy. The other part is making it easier for doctors, nurses, and specialists to coordinate care. The typical primary care doctor interacts with more than two hundred specialists. If everyone is sharing electronic files and located nearby, it makes managing a patient with a complicated illness a lot easier.

The mission has become even more urgent since the Affordable Care Act created incentives, and penalties for hospitals to improve care.

The Payoff

So far, medical homes, which have been around less than a decade, have a pretty impressive track record. They cut emergency room visits by up to 70 percent and hospital readmissions by 40 percent, according to an analysis by Washington D.C. based Patient Centered Primary Care Collaborative.

Credit The National Committee for Quality Assurance
There are more than 250 Patient-Centered Medical Homes in Texas recognized by the National Committee for Quality Assurance.

  It’s no surprise they’re gaining traction in Texas. There are already more than 250 patient-centered medical home sites, with 1,200 clinicians, according to Kristine Thurston Toppe at the National Committee for Quality Assurance. She says there’s been a significant increase in interest since the Affordable Care Act took effect. Part of that is due to the law’s incentives to focus on primary and preventative care – main features of any medical home practice.

“I would say over the past three years we would see an average of four to five hundred applicants per month,” Toppe says.

In addition to JPS, other major North Texas hospitals – including the Baylor system, Methodist, Parkland, UT Southwestern, and Children’s – have embraced the model.

Cigna HealthCare, BlueCross BlueShield and other insurers are also running medical home pilots.

BlueCross BlueShield of Texas is running several pilots in North Texas and in 2010 saved an average of $10.50 a month, per patient. It doesn’t sound like much, but with 25,000 patients that works out to more than three million dollars a year.

It’s those kinds of savings the Affordable Care Act is hoping to encourage – by offering incentives to create medical homes to treat veterans, people on Medicaid, and those who are chronically ill.

Looking Forward

Even though more medical homes are being formed every month, the majority is still located in urban areas, and include few small to medium sized clinics.

Sue Bornstein, the executive director of the Texas Medical Home Initiative, says part of the reason expansion is slow is because transitioning from a traditional medical practice to the medical home is a big investment.

“This is a resource intensive undertaking,” Bornstein says. “It does take time, effort, there’s cost involved.”

The initial results are promising, she says, but she says we’ll have to wait to see whether the potential savings can be extrapolated over large populations.