Ask the Doctor: Medical Home

Medical Home is one of those not-so-easy-to-wrap-your-head-around terms related to health care reform. But here's what you really need
to know about it: A Medical Home is good for you.

Dr. Donald Skinner

Dr. Donald Skinner
McFarland Clinic
Family Medicine

To help you understand why, we asked Dr. Donald Skinner, Family Medicine physician and McFarland Clinic Medical Director, to explain the concept further.

Q: What is a Medical Home?

A: It’s a model of care that has been shown to decrease emergency room visits and the need for some hospitalizations. The goal is to keep patients healthy and coordinate their care.

The term Medical Home refers to primary care offices that meet a set of standards and criteria for improving health care. These standards are established by the National Committee for Quality Assurance (NCQA), which recently accredited two McFarland Clinic primary care offices as Medical Homes.

NCQA defines Medical Home as "a health care setting that facilitates partnerships between individual patients and their personal physicians, and, when appropriate, the patient's family. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner."

Q: But don't patients receive coordinated care now?

A: McFarland Clinic is constantly working to improve care through personalized and coordinated care. I think we're doing it successfully. When you look at our care data compared to other clinics in Iowa and nationally, McFarland Clinic continually ranks low in cost measures and above average in quality of care. This is the result of coordinated care. Medical Home should further improve coordination of care.

Q: What should patients do if they are part of a Medical Home?

A: There are two important steps patients should take in their care. First, patients of all ages should establish care with a trusted health care provider. (Patients do not have to be a part of a Medical Home to select a provider to receive ongoing care.) This doctor is referred to as your Primary Care Provider (PCP). Second, patients should schedule
annual exams with PCP.

Q: There was a study about five years ago indicating that less than 25 percent of adults in the U.S. get an annual physical. There's also been ongoing debate about the value of an annual exam. Are they necessary and why?

A: While there has been controversy, I am a proponent for annual exams. I believe the preventative examination is the best time to assess your health risk factors and perform the appropriate testing based on age to keep you healthy.

Information gathered at the annual exam can help both the provider and the patient be proactive in managing signs and symptoms that could lead to a serious illness.

Q: It seems that the patient/primary care provider relationship is crucial to all of this.

A: It absolutely is. A primary care provider helps a patient deal with day-to-day issues of health and chronic conditions, as well as guide and direct
care when a health concern requires other providers. The Medical Home expands the relationship to include other members of the provider’s health care team. The goal is to help you be more proactive in your care—both in preventative care and management of chronic conditions. Our offices at Family Medicine East and North are nationally certified and are instituting programming to achieve those goals.