Durbin and Burr Introduce Bipartisan Medical Homes Act

[WASHINGTON, D.C.] – Assistant Senate Majority Leader Dick Durbin (D-IL) and Senator Richard Burr (R-NC) introduced the bipartisan Medical Homes Act this week to improve health care quality by helping states implement patient-centered medical home programs under Medicaid and SCHIP.


“At a time when both health care costs and chronic illnesses are on the rise, we need a better way to provide care that is accessible, comprehensive and cost-effective,” said Durbin. “The medical homes concept –continual care coordinated by a personal physician – has proven that it can reduce costs and lead to better health outcomes for every American. Our Medical Homes Act would make federal funding available for states to implement this model to care for our nation’s most vulnerable - low income children and families.”


The Patient-Centered Medical Home Program is intended to assist Medicaid and SCHIP beneficiaries who are most likely to hop from provider to provider, without a continuous source of care, records and follow-up. To participate, beneficiaries will be assigned a personal primary care provider as their source of first contact. That personal primary care provider, who has signed up to participate in the medical homes program, will spend more time with the patient during visits, keep close records of the patient’s personal health history, communicate with other health care providers when patients go elsewhere to seek care, follow up with the patients with phone calls, make referrals to other health services as needed and create an ongoing relationship to provide first contact, continuous and comprehensive care.


The Medical Homes Act would also encourage local input in the delivery of healthcare, creating a local steering committee and a medical management committee. The model incorporates social services, public health, public hospitals, community health centers, and physicians to take responsibility for all of the patient’s health care needs or for appropriately arranging care with other qualified professionals. Providers participating in the model will receive a per member-per month care management fee to subsidize the extra costs associated with patient-centered care. Medical homes would also increase the use of key health care staff, such as case managers. Case managers often arrange transportation, follow-up with patients that visited the ED for non-emergency care, send reminders about flu shots and checkups, and provide referrals to social services or public health department programs.


In addition to improving care for patients, one of the primary goals of the medical home program is to increase cost effectiveness of health care. According to the Agency for Healthcare Research and Quality, 4 million hospitalizations could be prevented and billions of dollars could be saved each year by improving the quality of primary care and getting more Americans to adopt healthy behaviors—both key elements of the medical home model. Since instituting the medical home model, the state of North Carolina has seen savings of $224 million/year since 1997. From July 1, 2003 – June 30, 2004 the state spent $28.5 million on payments to networks and physicians and there was $124 million in savings. The medical home program also aims to improve communication among primary care providers, increase school attendance, decrease duplication of health care services provided; inappropriate emergency room utilization; and avoidable hospitalizations.


Medical homes have been accepted by leaders of four primary care professional associations representing 330,000 doctors: the American Academy of Family Physicians, the American College of Physicians — Internal Medicine, the American Academy of Pediatrics and the American Osteopathic Association.