Magazine article Drug Topics

Medication Management a Cornerstone of Patient-Centered 'Medical Home'

Magazine article Drug Topics

Medication Management a Cornerstone of Patient-Centered 'Medical Home'

Article excerpt

In the past two years the so-called "medical home" concept has become a key part of healthcare reform, with medication management being a major part of the concept.

The basic concept of medical home is the primarycare provider taking responsibility for a patient's health and coordinated care - with the provider being compensated for his efforts. Exactly how pharmacists would be connected to the process is still being worked out.

The medical home concept has gathered sustained interest as well as resources for trials from large employers, health plans, local groups, Medicaid, and Medicare. For example, the Patient-Centered Primary Care Collaborative (PCPCC) Web site lists 16 local and state demonstrations. The Commonwealth Fund lists a number of grants for medical home demonstrations. Additionally, a project sponsored in part by the collaborative is aimed at helping state Medicaid programs adopt the model. And a major three-year demonstration under Medicare, mandated by Congress in 2006 and involving possibly eight states, is due to begin next year.

The PCPCC was formed about two years ago to advocate for the medical home concept. It has about 180 members, including major employers such as IBM, FedEx, and Wal-Mart. It also includes healthcare professional associations, health plans, drug companies, and others.

The collaborative says that, in nations in which there is more focus on primary care, people live longer, are healthier, and are more satisfied with care, "and everyone pays less."

A foundational document for the push in this country is the statement of "joint principles" that was adopted last year by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), and the American Osteopathic Association (AOA). The principles say that, in the medical home, the personal physician leads a team that collectively takes responsibility for ongoing care of the patient; care is coordinated across the complex system; and it is facilitated by registries, health information exchange, and other means.

The principles also state that, among other elements, the medical home payment structure should reflect the value of a physicians and non-physician staffs work to manage care outside the face-to-face visit. …

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