Medicare Faqs

What Is a Medical Home?
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Employers, insurance companies and government insurers like Medicare are turning to coordinated care options such as the medical home concept. This concept involves centrally coordinating treatment and patient referrals as a way to keep costs down. As part of this program, a health care provider, such as a primary care physician, often agrees to coordinate health care for these patients for an extra monthly payment. The idea behind a medical home is that patients get higher-quality health care, including the ability to receive specialized services at a doctor's office, where costs are much lower than at a hospital. The patient also is encouraged to maintain a closer relationship with doctors and other staff members at the medical home.

“Although there is no single standard definition of a medical home, there is an agreed upon set of principles behind the concept, and most medical homes share common elements,” according to a report in Health Affairs magazine. “For example, each patient has close contact with a clinician (physician, nurse practitioner, or physician assistant) for continuing care, and that clinician takes the lead when referring the patient to specialists. Medical homes also make extensive use of electronic health records and seek active participation of the patient and his or her family.”

The Secretary of Health and Human Services has the authority to expand the use of medical homes within the Medicare system and to pay extra fees for such things as phone consultations and emails, which are not covered under the regular Medicare system.

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