What is a Medical Home?

A Medical Home is not a building, a house, or a hospital...it is an approach to providing health care to Children and Youth with Special Health Care Needs (CYSHCN) by using the child’s primary pediatric practice as a hub for coordinating all medical 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.

What does CYSHCN mean?

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.

What is a “special need”?

“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.

What is EPIC-IC (also known as the Pennsylvania Medical Home Initiative)?

EPIC-IC is a non-profit quality improvement program that works with pediatric practices in Pennsylvania to help them implement Medical Home concepts.

How was EPIC-IC founded?

EPIC-IC (Educating Practices in Community-Integrated Care) 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 Health 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 EPIC-IC. EPIC-IC is one of many programs belonging to the American Academy of Pediatrics, a non-profit organization specializing in pediatric advocacy.

Why do practices in Pennsylvania join EPIC IC?

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.

Why is the Medical Home approach important?

• Advances in health care have made it possible for increasing numbers of CYSCHN to be care for in the home and community, but doing so requires a new system of approaches to providing care.
• All pediatric and family practices have some CYSCHN 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 purchasers a measure of quality of care.
  

Who is part of a Medical Home?

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).