Health care under one roof

COEUR d'ALENE - The medical home model of care - a system of primary medical care delivery designed to enhance the physician-patient relationship, raise the quality of care and drive down health care expenses - is going to be piloted in Idaho this winter.

Gov. Butch Otter announced Thursday that physicians, hospitals, clinics and health insurers are on board as they prepare to move forward with the two-year Idaho Medical Home Collaborative project.

"Thousands of Idahoans will benefit from coordinated health care delivery through this initiative," said Otter, in a prepared statement. "Working with Idaho Medicaid's Home Health Project, this collaborative is exactly the kind of grassroots, Idaho-driven approach that can help responsibly address costs, which are the primary barrier to health care access for too many citizens. And we're doing this on our own - without federal mandates."

Medical homes aren't what their name sounds like. Patients don't live in them.

"The concept is to collect a variety of practitioners in a more collaborative or cohesive practice," explained Walt Fairfax, Kootenai Medical Center's chief medical officer.

Through the years, increased technology and an increase in the different types of practitioners who provide various elements of care have made it more difficult for patients to receive the care they need through a primary care office, Fairfax said.

"With regard to cost-effectiveness, if you begin to fractionate medical care so you have to go to a variety of different practitioners for basic care, it becomes very expensive," Fairfax said.

The medical home model of care aims to turn that around.

"A medical home might look like a couple of primary physicians, a psychiatrist perhaps, maybe a pharmacist, all operating out of the same location," Fairfax said.

Patients will have more seamless access to the types of treatment they need with a focus on preventative, coordinated, continuous care rather than receiving acute care as symptoms emerge.

The medical home system also reforms the way health care is paid for, shifting the focus of the payment system from quantity to quality and value.

A medical home might be paid a certain amount to provide complete care for a family or an individual, he said.

Development of the framework for the Idaho Medical Home Project has been under way for the past two years, since Otter issued a 2010 executive order creating the Idaho Medical Home Collaborative, a partnership of private and public insurers and medical leaders throughout the state.

The collaborative plans to have 12-15 primary care practices participating in the two-year program, and they are accepting applications through Sept. 5.

"We, as well as other groups across the state, have an environment where we can foster a patient-centered medical home," Fairfax said.

The hospital is in the process of filing its application, he said.

"There are other physician groups in this area working on this also," Fairfax said.

Technology is also a key component to the medical home system, he said. It calls for online services for patients and new communication options, including email.

"For example, you'll be able to go to the web to find out what your lab results are or access your medical records," Fairfax said. "It's all about that, improving the patient's access to what they need."

Fairfax said he likes the way the program is being piloted throughout the state, and said it's likely that one or more of the pilot medical homes will be in Kootenai County.

"It's essentially changing the way we deliver medical care," he said.