Frequently Asked Questions about MHI
The medical home is the organizational setting that integrates preventive services, acute illness management, and chronic condition management. An effective medical home seeks to identify the broad spectrum of a child and family's needs at a given point in time (including preventive care and psychosocial items), as well as to anticipate and design care to address future needs.
The medical home coordinates among agencies and services in the child's community (termed "horizontal coordination") and within the health care system ("vertical coordination") to address current health needs. It also provides continuity over time to address future health needs; care in a medical home spans childhood through adolescence and facilitates a smooth transition to adult services. The medical home fosters competence in patients and families as its key strategy to achieve positive results.
The Medical Home approach is important because...
- Advances in health care have made it possible for increasing numbers of CYSHCN to be cared for in the home and community, but doing so requires a new system of approaches to providing care.
- All pediatric and family practices have CYSHCN (Children and Youth with Special Health Care Needs) to be cared for in their practice.
- A medical home provides acute, chronic, and preventive medical care services. Preventive services (physical exams, developmental screenings, patient/family focused education, immunizations, access to community-based services) promote optimal health.
- Patient satisfaction is increasingly used by insurance companies as a measure of quality of care.
The goal of the Medical Home Initiative is to provide CYSHCN with health care services that are accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally-competent.
In a Medical Home, health professionals and families work as a team to access all medical and non-medical services necessary to help children reach their full potential.
Pediatric practices who participate in the EPIC-IC Medical Home Initiative are motivated by a desire to improve quality of care for children and youth with special health care needs in a cost-effective manner.
A medical home consists of a Primary Care Provider (physician or nurse practitioner), pediatric office staff, allied health care professionals, the child/youth, the family, the family's community, and pediatric subspecialists (if necessary).
The PA Medical Home Initiative was founded when the U.S. Department of Health and Human services created a series of goals designed to "bring better health to all people in this country." The initiative was called Healthy People 2010. Several of the Healthy People 2010 goals are targeted specifically at improving care for CSHCN (Children with Special Health Care Needs) and YSHCN (Youth with Special Health Care Needs):
Children will be screened early and continuously for special health care needs.
Families of CSHCN will participate in decision making at all levels and will be satisfied with the services they receive.
CSHCN will receive regular ongoing comprehensive care within a medical home.
Families of CSHCN will have adequate public and/or private insurance to pay for the services they need.
Community-based service systems will be organized so families can use them easily.
Youth with special health care needs (YSHCN) will receive the services necessary to make transitions to all aspects of adult life.
Recognizing that the Healthy People 2010 goals could only be met by working together at federal, state, and local levels, the Maternal Child and Health Bureau (MCHB) and the Pennsylvania Department of Health (PA DOH) provided funding to create the PA Medical Home Initiative (PA MHI). PA MHI is one of several programs belonging to the Pennsylvania Chapter of the American Academy of Pediatrics, a nonprofit organization specializing in pediatric advocacy.
CYSHCN stands for Children and Youth with Special Health Care Needs. Recent survey data from the National Center for Health Statistics, Centers for Disease Control and Prevention estimate that 13% of children nationwide have special health care needs.
A child with "special needs" refers to any child who has or is at risk of developing chronic conditions which require health services of a type and amount not usually required by children of the same age. This includes conditions such as asthma, ADHD, rare genetic disorders, congenital heart defects, severe allergies, developmental disabilities, emotional or behavioral health needs, and hundreds of other disorders.