MCHB: An Update and Next Steps on Medical Homes

By Marie Y. Mann, MD, MPH
Genetic Services Branch, Maternal and Child Health Bureau 

Not unlike the tortoise in the fable “The Tortoise and the Hare,” we are moving steadfastly toward the goal of optimal child health and development within a comprehensive, integrated system of care for all children, including those with special health care needs.  

We believe achieving this goal will rely on adoption of the patient/family centered medical home (P/FCMH) model, which combines the central focus on the patient and family with core tenets of primary care and continuous quality improvement. This model broadens the traditional focus on acute care to include prevention and well care as well as chronic care management. It provides a framework for addressing health in the context of social, behavioral, psychological and environmental influences as expressed by the Life Course Perspective. 

Successful implementation and evaluation of the P/FCMH model requires continual collaboration at the family, provider, community and state level. Such efforts may involve clinicians partnering with patients and families to conduct quality improvement in the clinical settings or state agencies providing support to sustain the desired changes at the practice level.  

This year we will celebrate All Aboard the 2010 Express, our ongoing plan to achieve coordinated systems of services for children and youth with special health care needs and their families. The P/FCMH has been, and will continue to be, a key element of our plan. One of the most significant developments during the decade has been the widespread recognition that medical home is the model of care that all children and youth deserve. We also know, from the National Survey of Children’s Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN) that only about half of children and youth in the United States currently have access to this model of comprehensive health care. We will continue to sponsor initiatives and implement funding strategies that will support innovations and measurement-based efforts fostering collaboration, as well as promote evidence-based and culturally effective services, and dissemination of promising practices, lessons learned, and successful policy strategies. 

The Health Reform legislation contains provisions that are relevant to advancing the P/FCMH model, particularly for the Medicaid and CHIP populations. State Title V agencies can take this opportunity to partner with their state’s Medicaid agencies, Primary Care Organizations, family and child health professional organizations to share resources and expertise for achieving the vision. Join us in October 2010, along with the 75th Anniversary of Title V, as we celebrate All Aboard the 2010 Express, and plan for the next decade.