The basic concepts and tenets of the integrated patient-centered medical home at Walter Reed National Military Medical Center includes Stable Primary Care Manager, Team Based Healthcare, Improved Access, Proactive Healthcare, Coordination with Medical and Surgical Specialists and Improved Communication and Information Systems. Medical Home patients have an entire team responsible for their healthcare which includes the Primary Care Manager, a Registered Nurse (RN), a Licensed Practical Nurse (LPN), and/or a Hospital Corpsman.
The Air Force has employed their version of the PCMH, termed the Air Force Patient-Centered Medical Home (previously the Family Health Initiative), at several of their bases within the United States. The Air Force PCMH was modeled after the qualities and goals of a PCMH. These Air Force PCMH practices are within the Air Force Bases themselves, and each of them has a patient panel of military beneficiaries (active duty members, retirees, and families) creating a unique healthcare environment.
The VA’s Veterans Health Administration (VHA) operates one of the largest integrated health delivery systems in the United States, delivering comprehensive care to approximately five million Veterans. VA’s PCMH Patient initiative includes a care team model that incorporates multidisciplinary clinical and support staff who deliver all primary care and coordinate the remainder of patients’ needs, including specialty care. To optimize workflow and enhance continuity of care, staff are organized into “teamlets” that provide care to an assigned panel of about 1,200 patients.
The Maryland Multi-payer Patient-Centered Medical Home Program (MMPP) began a three‐three year pilot study in 2011 to test the PCMH model of care, including 52 primary and multi-specialty practices. The practices are comprised of both private and all of the federally‐qualified health centers located across the State. Maryland law requires the State’s five major carriers of fully insured health benefit products (Aetna, CareFirst, CIGNA, Coventry, and UnitedHealthcare) to participate in the MMPP.
To improve Air Force primary care and achieve better health outcomes for our patients, the Air Force implemented the Family Health Initiative (FHI) in 2009, which is a team-based, patient-centered approach building to the Patient-Centered Medical Home (PCMH) concept established by the American Academy of Family Physicians. In 2011 the Air Force had implemented PCMH at 23 of its MTFs and ultimately will expand it to all facilities.
To implement PCMH principles, the Bureau of Medicine and Surgery (BUMED) formally developed its PCMH model Medical Home Port (MHP) and is in the process of implementing MHP across its enterprise. Medical Home Port helps provide primary care in a way that best meets the needs of Navy Medicine’s beneficiaries. The Medical Home Port team ensures that care is all-inclusive and integrated with all other care provided within the healthcare system.
In the Community Based Medical Home, the healthcare team develops a comprehensive care plan as soon as the patient enrolls and then proactively engages the patient as a partner in care. This face-to-face encounter build trust, improves communication, and lays the groundwork for providing continuous care. As part of the Army's commitment to improved access, the Community Based Medical Homes offer a broader range of access options: group visits, enhanced telephone communication and web-based communication.
