Patient Centered Medical Homeand

The Medical Neighborhood

Daniel Maher, MD, MPH, FACPCAPT, MC, USN

Director of Medical ServicesNaval Medical Center San Diego

6 October 2011

Disclaimer: The views expressed in this article are those of the author and do

not necessarily reflect the official policy or position of the Department of the

Navy, Department of Defense, or the United States Government

Objectives

• Describe the ‘big picture’ • Identify the #1 goal of the Medical Home Port• Recognize what policymakers are saying

about Medical Homes• Explore ideas for linking Medical Homes with

the Medical Neighborhood

Medical Motel 6

To

Home Sweet Medical Home

To

The Medical Mansion

Step Back and Remember

A simple concept:

“Encourage patients to become active participants in their own health, work with them to keep them well and out of the hospital and emergency room, and guide them through the system when they need care.”

(Healthcare Executive, Mar/Apr 2011, p27)

The View from the top

http://www.youtube.com/watch?v=-yGS7jxgyVk

http://www.youtube.com/watch?v=tlJBZQZJe-w&feature=related

http://www.youtube.com/watch?v=g3eNW_CmG1o

http://www.bethesda.med.navy.mil/MedicalHome/MHVideo.aspx

http://www.navy.mil/swf/mmu/mmplyr.asp?id=16037

http://www.emmisolutions.com/medicalhome/acp/english.html

The Metrics

• ED utilization• Hospitalization rates• Specialty care utilization• PCM and Team Continuity• Same Day access to care• Patient satisfaction• Staff satisfaction• COST aka PMPM

PMPMPer member per month = the cost of providing

care for your enrolled panel of patients

Cost of care directly related to utilization

(ED, Hospitalization, Specialty)

Bottom line – decrease the cost of care while improving the quality of care

The Med Home Team

TRUST- “Trust no one, verify everything”

- “Show me the data”

- “I’ll do it myself”

- “It’s faster if I handle it all myself”

Building Trust

- Are you still asking about, ordering, documenting health maintenance services?

- Does your MA or Corpsman copy forward the PMH and Med list for you?

- Do you know all the support staff on your team by name?

- Do you meet with your team on some regular basis to discuss the health issues of your enrolled panel of patients?

- Does your team have a physician leader who actually leads the team in improving the care of your enrolled panel?

The Medical Mansion

A simple vision:

“Encourage patients to become active participants in their own health, work with them to keep them well and out of the hospital and emergency room, and guide them through the system when they need care.”

(Healthcare Executive, Mar/Apr 2011, p27)

The Medical Neighborhood

The Medical Neighborhood

In Conclusion• The Medical Home is complex – perhaps overwhelming

• Step back and focus on a simple concept of the Medical Home

• The Medical Home is marketed as the answer to the rising cost of care

• For Navy Medicine the PMPM is cost of care

• Link the Medical Home with your local Medical Neighborhood

QUESTIONS