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Health Information Center

The Medical Home Principle

A family-centered, coordinated care approach for your child or young adult with special health care needs or disabilities

What is a Medical or Health Care Home?

A medical home is not a building. It’s a patient, family-centered, comprehensive, continuous, and coordinated approach to providing care for children with special health needs and disabilities. Through a medical home, a doctor and their staff respect you as a team member who understands your child’s needs best. This approach ensures that your child’s needs are met.

How does it work?

In a medical home, information and concerns are shared by everyone caring for your child. Needs are addressed in a collaborative way, with a certified clinical coordinator helping to manage your medical home team. A written care plan is shared with your family and child’s health care providers. To participate
in a medical home, first choose a physician you trust and inquire if that clinic is a Medical Home or Health Care Home (HCH). This physician, along with his or her staff, will be your primary care providers who help you:

  • Coordinate care for your child
  • Develop care plans with other providers
  • Communicate with other professionals
  • Exchange information
  • Share decision-making responsibilities
  • Promote health and quality of life for your child

What are the characteristics of a Medical or Health Care Home

In a medical home, the primary care physician and other health care providers:

  • Have access to all your child’s medical information through a single portal
  • Listen to your family’s concerns and needs
  • Work in partnership with your family to ensure that your child’s and family’s needs are met through a process of shared decision making
  • Help to develop a care plan for your child when it is needed

This allows you to:

  • Have all your child’s needs met through a single clinic and hospital
  • Optimize communication with your team of doctors and support staff by routine and coordinated exchanges of information
  • Share your family’s concerns and priorities with the entire team, as well as ask to have things clarified or explained differently to your family if necessary
  • Be an integral part of the your child’s health care team to ensure that your child’s needs are met

Why is this important?

As a parent of a child with disabilities or chronic health conditions, you know that it can be difficult to coordinate information and services among health, education, insurance, and social service professionals. Your child and family can benefit from a familycentered, team approach to providing health care in a medical home.

What are the benefits of a Medical or Health Care Home?

  • Better organized care
  • More efficient communication
  • Support from a team of caregivers
  • Stronger relationships with care providers
  • Reduction of duplicate services and tests
  • Improved health care for your child

How do I find one?

  • Ask your clinic if they are a certified Medical Home or Health Care Home
  • Talk with your doctor and other providers about how to coordinate your child’s care by setting up a medical or health care home
  • Call PACER at (952) 838-9000

The American Academy of Pediatrics (AAP) believes that all children should have medical care that is:

  • Accessible: Care is available 24 hours a day, seven days a week in the child’s community
  • Family-centered: The doctor recognizes that the family is the principal caregiver and the center of strength and support for their child
  • Continuous: The child will have the same primary pediatric health care professionals available from infancy through adolescence
  • Comprehensive: A medical home covers sick and well care, as well as education and community referral needs
  • Coordinated: The hallmark of a medical home is a certified care coordinator whose job is to support the family and connect them to educational community services, while coordinating medical care
  • Compassionate: Concern for the well-being of the child and family is expressed and demonstrated
  • Culturally effective: The family’s cultural background is recognized, valued, and respectedDiscuss ways to improve your child’s care and how to begin setting up a medical home with your doctor or other care providers.

Questions to ask the doctor about Medical Home or Health Care for a Child or Youth with Special Health Care Needs (CYSHCN)

  • Does the doctor have experience with and enjoy working with children and youth with special health care needs (CYSHCN)?
  • Does the doctor have time in his or her practice for CYSHCN?
  • Can you schedule longer appointment times for your child, if needed?
  • Does the doctor have evening or Saturday hours?
  • Is the doctor willing to partner with your family to develop personalized care plans for your child?
  • Does the doctor or clinic staff communicate and coordinate with other providers or specialists involved in your child's care?
  • Will the doctor be accessible by voicemail or e-mail outside of appointment times?
  • How will emergencies be handled by the practice, especially if the doctor is unavailable?
  • Is there a care coordinator and primary contact for your child's care plan?
  • Is the clinic a certified Medical or Health Care Home? (If so, the clinic can bill public insurance for coordinating care.)