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Medical Homes in Washington: Reaching the “Tipping Point”

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Maxine Hayes, MD, MPH Medical Home Conference May 30, 2007. Medical Homes in Washington: Reaching the “Tipping Point”. Welcome & Introduction. What is a Medical Home?.

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Presentation Transcript
slide1
Maxine Hayes, MD, MPH

Medical Home ConferenceMay 30, 2007

Medical Homes in Washington: Reaching the “Tipping Point”

what is a medical home
What is a Medical Home?
  • A way of providing comprehensive, coordinated care that is built on a foundation of mutual respect and partnership between patients, their families, and health care providers. Also includes connection with community services such as family support.
defined by its components
Accessible

Continuous

Comprehensive

Coordinated

Family-centered

Compassionate

Culturally effective

Defined by its Components
one of the six national performance measures for cshcn
One of the Six National Performance Measures for CSHCN
  • All CSHCN will receive regular ongoing comprehensive care within a Medical Home
slide6
Providers
  • Develop partnership of mutual responsibility and trust with family and child
  • Deliver or direct primary care
  • Manage and facilitate all aspects of child’s care coordination
slide7
Families
  • Diverse families empowered to play active role as a Medical Home team partner.
policy partners involved in moving mh concept forward include
Policy partners involved in moving MH concept forward include:
  • Medical Home Teams
  • Washington State AAP
  • Other providers (including oral and mental health)
  • Insurers
  • Families, schools, childcare providers
  • Interagency and community partners
we ve reached the tipping point
We’ve reached the “Tipping Point”!
  • “The Tipping Point, How Little Things Can Make a Big Difference” by Malcolm Gladwell (2000)
  • When an idea becomes commonplace, acceptable, part of the every day usage, and things start to change….
what s changing
What’s changing…
  • Medical Home concept and acceptance has grown!
  • Started with AAP in 1967.
history of mh for cshcn in wa
Medical Home Needs Assessment in 1993 led to 1995 “Training & Resource Project” with 12 county medical home teams.

“Promise to the State” (2001)

Medical Home Leadership Network grew out of this: now 21 teams

Medical Home Strategic Plan for CSHCN (2006)

History of MH for CSHCN in WA
doh medical home strike team
DOH Medical Home “Strike Team”
  • “Medical Home Strike Team” 2006-Present
  • Focusing on bringing statewide efforts together to create a Medical Home strategic plan for all children and adults
medical home summit november 2006
Medical Home Summit – November 2006

Beginning of a strategic planning process to spread the concept of Medical Home, using the new strategic plan for CSHCN as the foundation.

the tipping point what s changing
The Tipping Point - What’s changing…
  • There’s increasing agreement that MH means more than just having a primary care provider.
what s changing15
What’s changing…
  • Partnerships are expanding to include practitioners/specialties beyond Pediatrics.
  • Joint Principles of the Patient-Centered Medical Home, March 2007, exemplify broader acceptance.
2006 2007 public policy initiatives
2006-2007 public policy initiatives
  • State Initiatives that include Medical Home
    • SSB 5093 (Children’s Health Insurance- aka Cover all Kids)
    • Blue Ribbon Commission (insurance for all)
    • Kids Matter plan (early learning initiatives)
    • Autism Task Force recommendations
    • Oral Health State Access Action Plan for CSHCN
what s changing17
What’s changing
  • More communication between medical community, public health, early intervention
  • Family advisory groups
  • Dental homes integrating with medical homes
  • Head Start and Early Head Start require medical homes for children
new medical home tools
New Medical Home Tools
  • Medical Home website: www.medicalhome.org
  • Medical Home key messages document
  • Medical Home monograph
  • Parent/Family Medical Home Checklist
  • Oral Health and CSHCN monograph and website
  • Bright Futures Oral Health document for CSHCN
  • New brochures for parents and providers 2007-2008
  • Family Leadership Training Curriculum – CSHCN Program
medical home quality improvement
Medical Home Quality Improvement
  • Medical home is an effective approach to improving health outcomes:
    • Learning Collaboratives
    • Performance indicators in SSB 5093
together we can eliminate health disparities
Together we can eliminate Health Disparities
  • Significant health disparities
  • Medical Homes defined as culturally competent and family centered
  • Washington State’s increasingly diverse population requires providers to become well versed in cross cultural communication and care.
next steps
Next Steps
  • Develop strategies for financing care coordination
  • Seek additional funding, e.g. Epilepsy Grant
  • Support Learning Collaboratives
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What Teams will hear about today
  • Strategies that are working for teams in our state
  • Opportunities to share and learn from each other.
determinants of health

Determinants of Health

Multiple levels of influence

HEALTH

L

I

F

E

S

P

A

N

social determinants of health
Health

Behaviors and

Personal

Risk Factors

Institutionalized

Biases (racism, sexism, etc.)

Access to

Health Services

Trust in Health

System and

Research

Mental Health

and Social

Support

Stress due

To Social

Factors

Economic

Opportunity

and Equity

Education

Background

and

Opportunity

Environmental

Risk

Language and

Other Cultural

Factors

SOCIALDETERMINANTS OF HEALTH
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