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Demonstrating the value of the “medical home” concept

Another great local case study that could be held up as a national model is Alliance Medical Ministry.

Alliance Medical Ministry is a faith-based medical ministry that serves uninsured working families in Wake County. For the most part, Alliance operates like any other private doctor’s office. Board certified physicians provide general primary care to patients who pay a set fee up front, however they don’t bill insurance, Medicare or Medicaid. The fee covers time with a physician, any necessary lab work or x-rays, most medications and health education. Alliance links with many community partners to provide the highest quality treatment available. The comprehensive care provided includes acute and chronic medical care, urgent care appointments, preventive and health education, monthly screening eye exams for diabetic patients, all necessary lab work, free or reduced priced medications, monthly ENT and GYN clinics, bilingual services and 24-hour coordination of care including a bilingual after-hours answering service.

Approximately 25% of Alliance patients are direct referrals from local hospital emergency rooms who need follow-up care or a medical home. Over 60% of these referrals have never had health insurance or have been without it for over a year. Ninety seven percent of Alliance patients have an annual household income of less than $25,000; 49% are Latino, 29% are African-American, 4% are Asian-American, and 60% are women. All have a working adult in the household but have no insurance.

A survey of Alliance Medical Ministry patients clearly demonstrates the success of this medical home model:

  • Better Care, Better Health: 100 percent of patients experienced an improvement in their overall health. Before being treated at Alliance Medical Ministry, these patients often ignored medical issues due to concerns about high costs. More than two-thirds of those surveyed said they had refused to address medical issues at least three times in the year before becoming a patient.
  • Fewer Missed Workdays: 90 percent of employed patients missed fewer days of work due to illness.
  • Reduced Medical Costs: 86 percent of patients visited the hospital emergency department less frequently, resulting in 68 percent fewer emergency department visits. This results in significant savings to the patient, as a visit to Alliance Medical Ministry typically costs $10 while a visit to the emergency department frequently bills for $1,800 or more.

Establishing a national network of primary care providers will take significant time and resources, requiring changes in reimbursement for primary care physicians and a renewed commitment to develop a strong pipeline of these important, but often undervalued, physicians.

The Alliance Medical Ministry – and hundreds of other successful models across the country – demonstrates that pursuing the medical home concept is worth the effort.

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2 thoughts on “Demonstrating the value of the “medical home” concept

  1. 1) In Oregon, circa 2000, there were several primary care providers who were going broke dealing with Medicare, Medicaid and Ins. companies. The headache of billing and re-billing and denials were requiring a greater and greater admin staff to bill. (Perhaps that is the way presidents “create jobs”). After finding the root cause of the problem, they let the admin staff go, and refused Medicare, Medicaid and Insurance all together. They found that they could reduce the cost of an office visit to $40.00 CASH ONLY. They were then, and still are profitable.

    2) MEDISHARE (1-800-psalm23)has been providing coverage for over 50 years. They do not cover office visits, and should you become ill or injured, you would have to cover the first $250. Then everything from $250 to $50,000 is covered by each other in the org. (Biblical principle to “share each other’s burdeons”); above $50K a catastrophic (group) policy kicks in. Costs: Individual $70-$90 a month. Family: $350/month

    3) UMC Arizona – If you show up at the hospital without insurance, before you are seen, they sign (qualified individuals) up for medicaid … On the spot, so the visit is covered.

    4) In Washington State, the hospitals form a “hospital district” much like a fire district. Some tax, while others do not. However because they are a “Hospital District” they are officially government and qualify for the higher re-imbursement rate from medicare and medicaid. I believe it would take the legislature about 5 minutes to put through a hosptial district bill.

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