FeedbackJohn Muir Health started a Concord-based pilot project in May 2010 to begin implementing the Medical Home portion of health reform, focusing primarily on elderly patients with severe chronic conditions.
Dr. Mike Kern, senior vice president and medical director of quality at the John Muir Physician Network, said 500 patients are now involved, including 100 in the initial cohort.
That group has seen a 38 percent drop in hospital admissions and a 10 percent decline in emergency room visits, along with much improved participation in routine screenings for breast cancer and colorectal cancer, Kern said. Patient satisfaction with the program is also high, he said. “We help give them back some control. Some feel they’ve lost control of their lives.”
The Medical Home concept centers on delivering more coordinated, less confusing care and giving patients a central home they can count on. It includes doctors (12 initially), nurses, case managers and others, and reaches out to at-risk patients rather than waiting to hear from them.
Muir, which has campuses in Walnut Creek and Concord, is ramping up the effort in coming weeks to include pilots at the Rossmoor senior living facility in Walnut Creek and with the Muir Medical Group IPA, a 560-physician group.
The effort helps often-elderly patients “understand their meds better, feel they’re more connected to health care, and do better on quality measures,” Kern said. “They don’t want to go to the hospital (unnecessarily). The worst-case scenario for everyone is that they’re in and out of the hospital.”
