HONOLULU-
Gov. Neil Abercrombie announced a new healthcare model for the state’s 270,000 Medicaid recipients that seeks to streamline services by providing care at central locations.
Under the ‘medical home’ model patients would be served by primary physicians who would operate out of community health centers and other neighborhood facilities.
During a Friday press conference the governor said healthcare services currently delivered by the government are often fractured or disjointed.
“Everybody's been isolated and working in silos up to this point, so we're gonna have a home for everybody to be in - a cyber home if you will, a technological home, a conceptual home.”
The state’s human services director, Pat McManaman, explained Medicaid patients would be delivered healthcare and other services under one roof, unless of course a primary physician determined specialized treatment was required elsewhere.
“The medical home model will provide them with integrated primary healthcare, behavioral care and adjunct social services,” she said.
FAMILIAR CONCEPT
If the medical home concept sounds familiar, that’s because it is. Kaiser Permanente has been utilizing the model for decades, which depends on a database of electronic health records for individual patients.
In Hawaii, Kaiser operates a medical home facility in Hawaii Kai on Oahu and another in Wailuku, Mau. Both are certified by the National Committee for Quality Assurance, a non-profit group that strives to improve healthcare delivery.
Other health organizations within the state have began using the concept more recently.
Hawaii Pacific Health, a non-profit medical system that operates four hospitals and 44 outpatient clinics, implemented the medical home model eighteen months ago.
“We've got terrific results showing improved outcomes for patients with diabetes, high blood pressure - any number of chronic diseases,” said Dr. Ginny Pressler, executive vice-president for HPH.
FEDERAL DOLLARS AND CONTROVERSY
Hawaii is scheduled to begin implementing the medical home model in January, a full two years before key provisions of President Barack Obama's healthcare reform law kicks in. That could result in an influx of federal dollars.
“For every dollar we spend in implementing the patient centered medical home, we will get $9 in federal matching and that's tremendous,” said Lt. Gov. Brian Schatz.
However the medical home model is not without controversy. Since primary physicians are rewarded for keeping healthcare costs down, critics say it creates a conflict of interest between a patient and his or her doctor.
However Richard Bettini, the CEO and president of the Waianae Coast Comprehensive Health Center, told reporters the medical home model is a program based on results.
“If we deliver pay us more, if we don't deliver - don't pay us more,” he said.
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