In the face of a primary care crisis, Framing the Medical Home Model of Care: Blueprint from Early Adopters chronicles the provider and payor experiences on the road to establishing medical homes for their respective populations. This 45-page resource describes the skills, technology, cultural change and financial incentives necessary to transform a physician practice into a medical home. It also presents a game plan for health plans that are ready to embrace and reimburse this model of care.

Part of the Medical Home Compilation, a three-volume series with medical home case studies from APS Healthcare, the Commonwealth of Massachusetts, Community Care of North Carolina, Horizon Blue Cross Blue Shield of New Jersey, the Pennsylvania Medicaid Access Program and United Healthcare -Save 20% when you order the Medical Home Compilation Series.

Dawn Bazarko, senior vice president of clinical innovations for UnitedHealthcare, offers a payor's perspective as agent for the medical home based on UnitedHealthcare's experience from its medical home pilot. She shares feedback from consumer focus groups and suggests methods for dispelling consumers' misperceptions about the medical home. She provides guidance on consumer education and activation strategies and tips for marketing the medical home and measuring its outcomes. She also discusses opportunities for value-added partnerships for medical homes in care and disease management programs offered by external entities.

From the physician standpoint, the medical home provides multiple opportunities to reframe traditional care delivery, reshape medical professionals' attitudes, improve practice processes and share innovations with other providers. Dr. Lonnie Fuller, medical director for the Pennsylvania Medicaid ACCESS Plus PCCM-DM Program, describes the four requirements of the advanced medical home, including a critical cultural shift in the practice from "physician as boss" to one of collaboration and support. He weighs in on the workload, staff training and technology required to support the medical home model in a practice, and suggests how payment reform and collaboratives can help move practices toward clinical excellence.

In "Framing the Medical Home Model of Care: Blueprint from Early Adopters," Ms. Bazarko and Dr. Fuller furnish details on the following:

• Defining the payor's role as agent of the medical home;
• Helping practices meet the medical home designation;
• Distinguishing the medical home model from the traditional HMO "gatekeeper" model;
• Understanding the patient's role in the medical home partnership;
• Enabling patient activation and education;
• Marketing the medical home to consumers;
• Measuring the medical home's outcomes;
• Supporting the medical home model with training, technology and disease management;
• Meeting the four requirements of the advanced medical home for successful practice transformation;
• Avoiding the "master craftsman" syndrome in medicine;
• Using "Diffusion of Innovation" theories to spread best practices;

This report also summarizes the results of a 2008 HIN e-survey that captured medical home awareness and implementation levels by healthcare industry sector. The survey analysis also reveals the motivation, strategies and outcomes behind medical home adoption.

Table of Contents

• Advancing The Patient-Centered Medical Home with UnitedHealthcare
  • Primary Care in Crisis
  • Defining & Evaluating the Patient-Centered Medical Home
  • A Proven Approach to Patient-Centered Medical Homes
  • Patient Relationship & Care Coordination Critical to Consumers
  • Stakeholders’ Roles in the Medical Home Partnership
  • Physicians and Patients Evaluate the Experience
  • Marketing the Medical Home
• Case Study in Practice Transformation: The Medical Home for the Medicaid Population
  • HEDIS Data Indicates Need for Improvement
  • Prescription for Primary Care
  • Advanced Medical Home Requirements
  • Practice Transformation Skills and Support
  • Collaborations and Best Practice Diffusion
• Q&A: Ask the Experts
  • Measuring Improvement Outcomes
  • Managing Communications Among Providers
  • Developing Transition Payment Strategies
  • Grants and Funding Opportunities
  • Diffusing Best Practices to Remote Sites
  • Engaging Reluctant Practices
  • Launching the Program
  • Care Advocate Job Description
  • Handling Confidential Information
  • Building a Communications and Marketing Strategy
  • Coordination Across Multiple Payors and Health Plans
• Glossary
• For More Information
• About the Authors