The Free Press, Mankato, MN

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September 20, 2009

Our View: An improved medical model

Forget the acrimony of the health care debate and the frustration that we’ll not have any solutions to growing costs of health insurance: A project at the Mankato Clinic shows much can be done in medicine to provide better care at a lower cost.

The clinic is participating in a Patient-Centered Medical Home model authorized by the Minnesota Legislature about two years ago. The idea is to coordinate care of particularly chronic and costly cases in a way that essentially improves communication, and gets all the doctors, specialists, nurses, even county public health and school officials on the same page.

It’s a simple idea, but one that is badly needed.

The program was detailed in a Sunday Free Press story about a local family with a son with five major health problems, including epilepsy, cerebral palsy and autism. The clinic deserves recognition for participating in the program, which appears to be an exciting model for innovative treatment of chronic conditions.

The clinic’s Dr. Angela Townsend was on the statewide committee formed about six years ago to discover the benefits of the patient coordinated model. Research showed that when patient care is coordinated, the number of emergency room and hospitalizations drops. Serious and costly treatments are avoided. It also gives stressed parents more information, and more comfort in knowing their child will be receiving the best and the most coordinated care.

The state provides funding for the projects and there are numerous criteria clinics must meet to receive continued funding. The Mankato Clinic pediatrics department is using the medical home model currently, but officials hope to expand it to all areas of chronic condition treatment. The clinic also has started a similar initiative to work with patients suffering from depression.

The Legislature set up the pilot program of medical homes as part of a larger effort to hold down medical costs with the eventual goal to extend health care to all Minnesotans. It was small piece of a larger reform effort that was scaled down in part because of the cost and the state’s budget problems.

Clearly, Minnesota’s state budget situation hasn’t improved much in the last couple of years. But efforts like the medical home idea should be expanded. They are designed to eventually eliminate the wasteful fee-for-service billing currently in place that pays doctors for every treatment, regardless of their effectiveness.

The coordinated care of the medical home model creates cost savings and quality improvements. Such changes are drastically needed to keep skyrocketing insurance bills in check.

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