Patient Centered Medical Home and The Medical Neighborhood

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Patient Centered Medical HomeandThe Medical
Neighborhood

• Daniel Maher, MD, MPH, FACP
• CAPT, MC, USN
• Director of Medical Services
• Naval Medical Center San Diego
• 6 October 2011

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• 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

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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

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• Medical Motel 6
• To
• Home Sweet Medical Home
• To
• The Medical Mansion

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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)

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The View from the top

• http//www.youtube.com/watch?v-yGS7jxgyVk
• http//www.youtube.com/watch?vtlJBZQZJe-wfeature
  related
• http//www.youtube.com/watch?vg3eNW_CmG1o
• http//www.bethesda.med.navy.mil/MedicalHome/MHVid
  eo.aspx
• http//www.navy.mil/swf/mmu/mmplyr.asp?id16037
• http//www.emmisolutions.com/medicalhome/acp/engli
  sh.html

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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

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PMPM

• Per 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

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The Med Home Team

• TRUST
• - Trust no one, verify everything
• - Show me the data
• - Ill do it myself
• - Its faster if I handle it all myself

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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?

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The Medical Mansion
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• 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)

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The Medical Neighborhood
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The Medical Neighborhood
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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

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• QUESTIONS