SCHIP Legislation May 'Get the Medical Home Moving'

Congress will have an opportunity to include a provision for a patient-centered medical home as part of legislation that reauthorizes the State Children's Health Insurance Program, or SCHIP, said Rep. Patrick Kennedy, D-R.I., during a June 28 congressional briefing here.

Congress is expected to reauthorize SCHIP this year, giving lawmakers a "brilliant opportunity" to include the patient-centered medical home in an SCHIP reauthorization bill and to thus use the legislation to "get the medical home moving" on Capitol Hill, said Kennedy, in a briefing for congressional staff sponsored by the Patient Centered Primary Care Collaborative, or PCPCC.

The PCPCC is a coalition that comprises the AAFP, other health groups, major employers, a major consumer group and other stakeholders. The coalition has sent legislative proposals to Capitol Hill, asking lawmakers to give financial support to states wanting to make patient-centered medical homes a part of their SCHIPs.

Kennedy endorsed a letter sent by the PCPCC to the chairman and ranking member of the House Energy and Commerce Committee -- the House committee responsible for drafting SCHIP reauthorization legislation -- asking them to include a patient-centered medical home in the SCHIP reauthorization bill.

Specifically, that letter states, "Inclusion in SCHIP of language to encourage states to redesign their health care delivery models around the medical home will improve quality (and) increase patient satisfaction and cost efficiency. Modest per-capita care management fees to qualified medical homes, accompanied by requirements to report on performance measures (would) compensate medical practices for additional services and investments while holding them accountable for results."

Kennedy emphasized that most of the nation's health care dollars are spent on chronic care patients, giving added credence to the patient-centered medical home as a source of care coordination.

"Our health care system is not a health care system, it is a sick care system," Kennedy said. The nation could save billions of dollars by investing more in prevention and care coordination, which are hallmarks of the patient-centered medical home, he added.

"If we could have better wraparound services and medical homes for these patients where the delivery and coordination of care is put in place, we could do a great deal to bring down costs and expand care for the uninsured," Kennedy stressed.

Kevin Burke, director of the AAFP Division of Government Relations, said the patient-centered medical home is based on access, coordination and personalization -- three key factors that improve quality and reduce costs. Burke said the patient-centered medical home is "not business as usual," adding that it is organized differently than the current primary care office.