As physician groups and insurance companies explore various ways to implement the medical home concept, another organization has developed a set of nine principles
that it said seeks to advance the concept from the consumer’s—rather than the physician’s—perspective and is distributing them to state and federal lawmakers to help guide healthcare system reform proposals.
The National Partnership for Women & Families, a Washington-based consumer healthcare and workplace advocacy group formerly known as the Women’s Legal Defense Fund, developed the guidelines along with more than 20 other organizations such as AARP, the Alzheimer’s Association, the American Diabetes Association and the Service Employees International Union.
In the second consumer principle, which calls on the patient-centered medical home to take responsibility for coordinating its patients’ healthcare across care settings, it’s noted that medical homes should also have systems in place “to help patients with health insurance eligibility, coverage and appeals.” Under the third principle, which states that “the patient has ready access to care,” the new guidelines note that “the medical home is not a ‘gatekeeper,’ but rather facilitates connections to other providers and services, as appropriate.”
Unlike the principles developed in 2007
by the American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics and American Osteopathic Association, the new “consumer perspective” recommendations themselves don’t discuss how primary-care physicians should be reimbursed for care-management and -coordination services. Instead, in an addendum, it’s stated that the recommendations are provided in the context of other patient-centered initiatives and reforms including “changing the way providers are paid so they are both incentivized and adequately compensated.”
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