Medical home care approach improves efficiency and care at clinic for low-income families

The study, "Doing Well by Doing Good," outlines the evolution of a federally qualified health center (FQHC) at Stamford Hospital in Stamford Conn. The clinic was struggling to optimally treat a high-volume of patients, many with complicated health issues requiring more time than the scheduled 20-minute pediatric visit. With so many appointments lasting up to an hour, the clinic was unable to serve all of the children who needed care and did not receive enough in reimbursements to cover expenses.

The clinic received a grant to provide staff support to implement a Medical Home model of care for children with special health care needs. Medical Home is an AAP-recommended approach to providing accessible, continuous, comprehensive, coordinated, compassionate, patient- and family-centered and culturally effective care.

After Medical Home implementation, the clinic was serving more patients, as pediatricians focused exclusively on health care, while a care coordinator secured appointments with specialists, handled school issues, and performed other administrative functions. The clinic established processes that improved efficiency and achieved a 95 percent immunization rate, had fewer emergency room visits and reduced hospital admissions.

The clinic also created an enhanced care clinic for mental health services and an Easy Breathing asthma education program. The hospital foundation supported an obesity effort by providing a nutritionist and funding a 12-week, award-winning exercise program called KIDS FANS (Kids' Fitness and Nutrition Services). This obesity prevention program received the 2010 Connecticut Hospital Association Community Service Award presented by the Connecticut Hospital Association and the Connecticut State Department of Public Health.

"Physicians can use the Medical Home model to link preventive services, and to build programs to efficiently serve high volumes of patients, even in a federally qualified health center," said lead study author Madhu Mathur, MD, MPH, FAAP. "This model can result in outstanding immunization rates and collaborative efforts for problems like obesity."