Like many other employers, each fall GlaxoSmithKline holds an "annual enrollment period" when I enroll my family for health benefits. I usually continue with plan I'm already on, with the usual benefits, with the same doctor/practice for the past 10 years. My co-payments had gone up over the past few years, but what hasn't become more expensive?
So when I saw an announcement from GSK about the option to join a new kind of medical practice--a medical 'home' with NO co-payments--well, that got my attention.
"Patient-centered medical homes" or "medical homes" are the subject of much confusion. Many who aren't involved in the business of healthcare--and even some who are--often mistake the term for a bricks and mortar healthcare facility, a nursing home, or even a physician who makes house calls. Instead, a patient-centered medical home is more of a "virtual" home for your healthcare--providing patients with a single point of contact to help coordinate their medical care, arrange care with other healthcare professionals when necessary, and house their health records electronically.
GSK is offering access to a patient-centered medical home benefit to employees as part of a pilot program in North Carolina called First in Health. Together with other employers in the state, we're hoping to show that by coordinating medical care, we can improve the health of our employees and reduce healthcare costs.
I checked to see if my current doctor/practice was on the list of groups participating in this pilot program for GSK--and though many of my colleagues' doctors are on the list, mine was not. When it was time to get my flu shot, I asked the front desk if they were aware of the medical home and if they were planning to participate. No one seemed to know.
That's when I decided it was time to change, and started looking at other medical groups.
We had changed doctors in the past--when we moved, or when the kids were born, we found a pediatric practice. But that was more than 10 years ago, and I wasn't sure where to start. I found the list of practices our health plan offered as a medical home, and looked at their websites, and any information I could find out about them. I asked friends, neighbors, and co-workers. Finally my husband and I agreed on a smaller practice that could take care of our needs, as well as for our two children. I enrolled in the health plan's medical home option, and selected this practice as our new provider.
I stopped by to meet the office staff, and to let them know that I was changing to their practice to use my health benefits and they would be my medical home. The office staff was new to the concept, but eager to help, and we got the initial work started to transfer my family's health records after the New Year.
Since we each needed an annual physical, wellness checks, and medications, my husband, kids, and I scheduled introductory interviews with our new doctors and nurse practitioners, and set up individual plans for the year. Both of the kids were attending college out of town, but still covered by our health benefits, but it was important for them to begin to learn how to manage their own care, and be given individual options and education about their health. We were surprised at the time the staff spent with each of us, and amazed when we realized that many of the questions they asked about out health had not been posed previously. We each left the office with a plan, and knew what we needed to do before the next visit.
At my physical, the nurse practitioner spent more than 30 minutes with me, taking my history, and having the medical assistant get extra tests and lab work that I needed. I couldn't remember the last time I received that much attention from my doctor.
I knew I needed to lose weight and exercise more, and the nurse spent time with me exploring my options and what would work best with my schedule. I looked into programs that were offered at work, and programs that our benefits covered, and got started that week. I started taking advantage again of our benefit that reimburses for weight loss or exercise programs.
In the past 8 months I have lost 30 pounds. I've been exercising 3 days a week, and am going to weekly weight management meetings. My medications have been adjusted, and I look and feel great! I actually look forward to returning to my nurse for the next physical, and to show her the progress that I've made!
Looking back over the past year, my husband has also lost 20 pounds, and his lab tests show he is managing his health better as well. The kids are also more aware of what they need to do for their health, and taking a more active role...what a difference a year makes!
Change isn't always easy. But I've had to get over my "too busy to take care of myself" mentality. Our healthcare system is going through such a period of dramatic change, and there is so much noise out there about the many important shifts occurring to improve patient care and reduce costs. It can be hard to step back and think about what changes you and your family need to improve your own health. The patient-centered medical home required some thought, and some work, on my part. But this change has been the best decision of my life, and my family's lives as well.
This year, take some time to prioritize your health and think about the changes that may be right for you. Talk to your benefits manager or insurance provider and see if they offer a medical home benefit. Visit www.firstinhealth.org to learn about what GSK is doing, and the Patient Centered Primary Care Collaborative to find out who in your community is taking this new approach to wellness.