Florida Medical Home May Offer a Model for the Future of Senior Healthcare
Bowers, Lois A., Medical Economics
A conversation with Jay Wolfson, DrPH, JD
Jay Wolfson, DrPH, JD, is the Distinguished Service Professor of Public Health and Medicine and associate vice president for health law, policy, and safety at the University of South Florida (USF) in Tampa. He recently spoke with Medical Economics Editor-in-Chief Lois A. Bowers, MA, about an experimental Patient-Centered Medical Home and health law issues.
Q: You are co-principal and senior investigator for the USF Health-The Villages Health Status Sun'ey and Health System Innovation. Tell me more about that project.
A: The Viiiages is such an exciting and extraordinary opportunity for all of us, nationally, as a model, because it is a large community of 100,000 seniors. It is owned by a single entity and it is very well-organized and structured.
The owner/developer did not design a planned healthcare system, which is why he came to us and said, "Are you interested in partnering with us to build an innovative healthcare system with us that brings primary and specialty care together, that creates a medical care home, and that involves technology substantially in the management of patient care?"
Partnering with them is American Well, which is a virtual healthcare platform that presents some really cool telemedical interfaces, and we're bringing our electronic medical inftrmation expertise into this community, which has a fabulous capacity to market network, and implement very quickly.
Q: What kind of research are you conducting with this group?
A: We have started by talking to people in the community. We held dozens of focus groups for a year and a half that served as the basis of the survey that we conducted that was intended to establish a baseline of information about health status, health needs, and health behaviors in the comnmunity.
It's not a Framingliam study. We can't go back and identi~' individuals. But we have 37,000 responses out of 91,000 surveys that were sent out That is the largest percentage of responses of any survey at any time in the United States for an aging population, and the validity is just stunning.
Every month, we go there and hold seminars, and 800 to 1,200 people attend. We talk about orthopedics, diabetes, pulmonary diseases, electronic health records, and death and dying. They come out in droves. They tell us they want more involvement interaction, information, and participation. They want to be wired in.
This is a very well-defined community, so we have the chance to demonstrate how a medical home system really works.
Q: What will be included in this Patient-Centered Medical Home (PCMH) model?
A: There are going to be eight primary care pods in this large community, along with surgery and specialty care centers, and everything is going to be interoperable and connected.
The first clinic is open. There are eight primary care doctors and three nurse practitioners, and we have pharmacists, health coaches, and physical therapists on site and in the community.
The second clinic is guing to be open in March, and the other six will open in the next year. The specialty center is going to be open in March. That's going to be staffed by the University of South Florida.
The physicians we are recruiting are being recruited exclusively for purposes of participating in the PCMH. So we tell them they are going to be providing care to patients, and the compensation, at least in the Villages, is likely to be higher than average community compensation because the idea is to attract the right doctors from wherever and let them do what they want to do most
The idea of having a bona fide medical home, if you take it to its extreme, will include everything from soup to nuts, all the way to skilled care, home care, hospice care. When you look at the demographic dynamics of it, it is no different from the rest of the aging population of the United States. And there are lots of communities that are growing up to become like this, where they have comprehensive, coordinated, community-based functions that will be tied to healthcare. …