Medical Home Concept Needs Wide Support to Succeed

Communication, coordination and cost-sharing barriers need to be overcome

WEDNESDAY, Sept. 17 (HealthDay News) -- The 'medical home' model, whereby patients can enjoy coordinated primary care within a patient-centered practice model, must overcome several obstacles in order to succeed, according to an article published in the Sept. 18 issue of the New England Journal of Medicine.

Elliott S. Fisher, M.D., of Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H., writes that the medical home model has three main barriers to overcome, namely resistance to collaboration between primary care physicians and hospitals and specialists; a lack of public and political support; and difficulties in controlling costs.

These barriers can be overcome by requiring providers to connect at a certain standard with medical homes and for all parties to share information; establishing rewards based on performance measures; and fostering systems in which cost savings gained from integrated service delivery are shared, the author states.

"The medical home has great potential to improve the provision of primary care and the financial stability of primary care practice," the author writes. "What has been missing so far has been an effort to implement this model in concert with other reforms that more effectively align the interests of all physicians and hospitals toward the improvement of patient care. To deliver on its promise, the medical home needs a hospitable and high-performing medical neighborhood."

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