Health care under one roof - Coeur d'Alene Press: Local News

Health care under one roof

Idaho to pilot medical home model of care this winter

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Posted: Friday, August 24, 2012 12:00 am

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.

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  • my own opinion posted at 12:16 pm on Fri, Aug 31, 2012.

    my own opinion Posts: 397

    check this out and read the comments...

  • my own opinion posted at 10:52 am on Fri, Aug 31, 2012.

    my own opinion Posts: 397

    I never went back to tooth ackers again. they double dip! they like extra cash and overcharging your insurance. they hate receipts and EOB'S. proof is in the pudding. be a business person take charge.

  • my own opinion posted at 10:44 am on Fri, Aug 31, 2012.

    my own opinion Posts: 397

    They also take advantage of you, when they bill you wrong and you have paid your insurance they send collection after you even when you paid! never use your bank info especially when paying a hospital or any medical bill.
    M.O, western union. unless you have a medical code book at home demand an itemized bill always! you get that at a grocery store for foods you buy why not from a doctor? transparency should be in the medical field they ask us to pay with no proof to compare what they say we bought or owe just a bunch of codes and a bill total they put what they want i guess and stick it too the customer. I never figured out how my father used a pack of 24 maxi pads.....$25.00 a package. read the itemized bills ask them to print it is your right by law. call your insurance they work for you they do not want to be overcharged either. get your EOB i found by reading this a dentist in post falls on 10th street TOOTH A rips you off at the desk then bills your insurance and pockets the overpay from the desk they make you pay i compared what i was supposed to pay and what i did with my EOB they owed me a lot of money than they combined service charges to put off the total and hide it from me detecting it i got over 500 dollars back! in just a few visits they had extra money i wanted back oh yeah they said we can credit your account i said no i want my cash back or i get a lawyer! i had proof! if we all ask for our rights to be followed we can all get the services we pay for rather than just pay and take their word for it.

  • oatster posted at 6:13 am on Fri, Aug 31, 2012.

    oatster Posts: 32

    the health care org. here in CDA is a are most of the providers!

  • my own opinion posted at 7:36 pm on Sat, Aug 25, 2012.

    my own opinion Posts: 397

    My Doctor visits seem to fall on deaf ears (he is always breaking appointments and going out of the country or golfing or something) and me and doctor do not make a connection after 10yrs, I now see a nurse practitioner. Practitioners are very good and have more time (they are busy but are in the office more). I would like a "menu" of procedure prices hey they bill us and try to list a service but hide it all in "medical code" The blue box Hospital overcharges and always mess up the coding making your bill fat. regulation would be nice Obama care no way.

  • Bob Loblaw posted at 1:15 pm on Fri, Aug 24, 2012.

    Bob Loblaw Posts: 398

    This sounds like a bunch of happy-talk with no real substance. If you really want to lower the cost of medical care, try this:

    1)Eliminate the insurance monopoly mandated by law and allow insurance companies to compete in a National market.

    2)Tort reform - malpractice insurance is a HUGE overhead cost that doctors and medical facilities pass on to patients.

    3)Give patients access to price schedules. What other business do you know of where you go in having no idea what it is going to cost you until a month later? This will add consumer pressure to drive down costs when they can shop around.

  • LTRLTR posted at 8:40 am on Fri, Aug 24, 2012.

    LTRLTR Posts: 1171

    Info can be found at

    I don't seem to see any advantages to this plan after wading through all the flowery language.

  • DeNiles posted at 7:17 am on Fri, Aug 24, 2012.

    DeNiles Posts: 2450

    Are these places targeted for more rural arenas? I really do not see how this will streamline care or reduce its costs. Are all of these disciplines made available to every patient at every visit? Do they require that patients follow through? Will they all have diagnostics labs, Xray facilities and minor surgery facilities?

    Maybe it is just poorly written but this makes zero sense to me. If there's only one neurosurgeon per 150,000 residents it is still going to take some time before you get your appointment. They might get more continuity in lab results and interpretation but they could do that now if they simply paid more attention. But this sounds like we've got a bunch of MD's sitting in a building seeing one patient at a time for a thorough work over. How will they charge less for that level of service? If the patient does not follow through with the detailed care plan it will be no more comprehensive or effective.

    Lay out a network of competent Nurse Practitioners/P.A.s directing intake to regional centers like these and intake would be streamlined and less expensive. That broadens the medical access foundation, reduces costs and puts some intelligent direction to the initial physician visit. Most people do not need to see an MD for routine wellness care or minor medical care. People with serious acuity needs do need immediate care of a more intense nature. This doctor in a box concept is a waste of resources IMHO.

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