Medical Home

Patient-Centered Medical Home - Where does Optometry fit in?

The AOA remains concerned that this model may restrict access to eye and vision care and that the patient-centered medical home may resemble that gatekeeper model reflective in earlier managed care delivery systems.

Although there are several proposed variations of the patient-centered medical home, proponents seek to restructure traditional reimbursement practices, which currently encourage physician specialization, to support personalized primary care, with primary care physicians serving as coordinators of the health needs of their patients. The medical home concept is being promoted as a mechanism to provide a more efficient and cost-effective care delivery model for all patients, regardless of whether they have a chronic condition, an episode of illness or the need for health promotion and prevention.

Core Principles of a Medical Home:

• Personal Physician
• Physician Directed Medical Practice
• Whole Person Orientation
• Care is Coordinated and/or Integrated
• Quality and Safety
• Enhanced Access
• Payment Reform

The AOA remains concerned that this model may restrict access to eye and vision care and that this may resemble that gatekeeper model reflective in earlier managed care delivery systems. AOA urges optometrists to be aware of this recent growing trend in the transformation of the health care arena and to actively advocate optometrists role and value as primary eye care providers. Please be advised that this concept is being promoted at both the state and the federal level. Optometrists are encouraged to use the below AOA policy documents to advocate for optometry.

• AOA Executive Summary: Eye and Vision Care in the Patient-Centered Medical Home
• AOA Position Paper: Eye and Vision Care in the Patient-Centered Medical Home

State Initiatives

• Community Care of North Carolina program
• WA H 2660
• Pennsylvania Medical Home Initiative
• National Academy for State Health Policy (NASHP) Medical Home Webinars

Federal Initiatives

• CMS Medical Home Demonstration Project
• THRCA Legislative Provisions
• Medical Homes Act of 2007 (S. 2376) - seeks to create a medical home demonstration program for certain beneficiaries enrolled in Medicaid and the State Children's Health Insurance Program, or SCHIP.

Insurance Plan/Employer Interest

• AHIP Article on Medical Homes

Additional Resources

• The Patient-Centered Primary Care Collaborative
• NCQA Physician Practice Connections Patient-Centered Medical Home Program
• The Patient-Centered Medical Home History, Seven Core Features, Evidence and Transformational Change ( Robert Graham Center for Policy Studies in Family Medicine and Primary Care)
• Bridges to Excellence Medical Home
• Consumer-Purchaser Disclosure Project Medical Home Resources