Medical Home Training
A medical home is not a building, house, or hospital, but rather an approach to providing comprehensive primary care. The creation of a medical home for children with special health care needs and their families is an essential child health outcome promoted by the American Academy of Pediatrics. A medical home addresses how a primary health care professional works in partnership with the family / patient to assure that all of the medical and non-medical needs of the patient are met. A medical home is defined as primary care that is:
- Accessible
- Continuous
- Comprehensive
- Family-centered
- Coordinated
- Compassionate
- Culturally effective
The primary health care professional can help provide access to and coordinate specialty care, educational services, in and out of home care, family support and other public and private community services that are important to the overall health of the child / youth and family.
The Center for Infants and Children with Special Needs at Cincinnati Children's Hospital Medical Center provides access to training programs and resources to assist physicians and health care providers create a medical home for families:
Currently, Medicaid and Medicare do not cover physician billing for most of the special services provided by the primary care physician (PCP) in the Children and Youth with Special Health Care Needs (CYSHCN) Medical Home. Richard Tuck, MD, pediatrician from Zanesville, Ohio, is representing the American Academy of Pediatrics and is working with CMS Centers for Medicaid and Medicare Services to:
- Define three tiers of the medical home
- Determine the physician work involved in providing a medical home
- Determine the practice expense including staff time, medical supplies and medical equipment required in each of the three tiers of the medical home
CMS in now considering adding these care coordination codes to the Medicare Physician Fee Schedule (RBRV Scale) in time for the January 1, 2009 launch of a project under Section 204 of the 2006 Tax Relief and Health Care Act. Medicaid and the private sector have usually followed the lead of Medicare. This failure to reimburse physicians for care coordination codes has been a major obstacle for families of CYSHCN in finding a suitable medical home. Medical home concepts and practices may be adopted more readily once these physician fee codes are reimbursed.
Back to Top
If your questions are not fully answered by our Special Needs Resource Directory and its links, please contact us via email.
7/08
