¶ … medical home concept and describe the principles (operational characteristics mentioned above) of the PC-MH as defined by these organizations. How does this concept differ from the gatekeeper concept of Managed Care Organizations?
According to the 'gatekeeper' philosophy of health management organizations (HMOs), physicians are intentionally given incentives to reduce access to care. This is based upon the assumption that patients will want to obtain as much care as they can receive and physicians will want to bestow that care to please patients and incur more revenue. HMOs encourage physicians to do the opposite and often financially reward physicians for cost reductions and limiting access of patients to specialists or heroic treatments. In the HMO model, physicians try to restrict access to specialists when they do not deem it necessary.
In contrast, the medical home concept is viewed as a partnership between "individual patients, and their personal physicians, and when appropriate, the patient's family" (Joint principles, 2007, AAFP). In the PC-MH model, the physician is viewed responsible for arranging care to promote whole person wellness in a proactive fashion, including establishing connections with other physicians. Close communication between the patient, caregivers, and other members of the treatment team is vital. Instead of a gatekeeper, the PC-MH model views the primary care physician as a navigator of the healthcare environment. "The PCMH should ensure that the health care team pulls together to best serve patient needs in all arenas. In the PCMH, integration will have to be a system-property, with information systems, teams, and organizational linkages promoting integration" (Case for change, 2011, ADA).
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Patient Centered Medical Homes In the 1960s, the medical home concept referred to as patient centered medical home was developed.In order to reform the healthcare in the U.S.; the patient centered medical homes are evolving as a centerpiece of efforts (Bates, 2010). Basically, PCMH can be defines as a primary care model that offers coordinated and comprehensive care to the patients in order to improve health outcomes. PCMH is also recognized
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