Cecily O'Connor
RedwoodAge.com

The propensity of boomers to develop chronic health conditions as they age is paving the way toward a new health care model.

The "medical home" concept calls upon primary health care physicians to serve as coaches and advocates for patients. While physicians would be compensated more for the higher level of coordinating care, the benefit to patients include a potential reduction in unnecessary tests and hospital visits, according to a new study from the Deloitte Center for Health Solutions.

"Given the clear correlation between runaway health care costs and lack of attention to chronic care, policy makers must think seriously about the medical home as a solution," said Dr. Paul Keckley, executive director of the center. "It's a logical approach to a persistent problem in US health care."

There is concern that the US health care system falls short in its efforts to effectively manage chronic conditions, with some studies reporting care is sufficient only 55 percent of the time, according to the Center.

An aging population only heightens care jitters. It's expected that six out of 10 boomers will have at least one chronic condition like diabetes or arthritis by 2030 when the last wave of their generation reaches 65, according to a 2007 report.

More Attention
The need to adopt a medical home model is driven by two factors: the shrinking number of primary care doctors due to difficult practice conditions and insufficient compensation, and the growing incidence and prevalence of chronic disease among the US population.

Longer lifespans are also a factor as researchers explore ways to lengthen lives and provide better, more cost-effective care to a fast-growing population of elders. The number of people over 100 is expected to jump to 1 million by 2030 from about 72,000 today.

The objective of the medical home model is to provide patients more attention - whether that's preventative or to address an acute illness.  A medical home also emphasizes enhanced care through open scheduling, expanded hours and communication between patients, physicians and staff.

The model isn't foolproof, however, and could result in some short-term pain. Expanding a primary care physicians' oversight could hurt hospitals and some health plans financially, as well as aggravate the current manpower shortage, the center cautioned.

Even so, efforts are underway to help physicians meet medical home standards. The National Committee for Quality Assurance launched a program in January to assess how medical practices are functioning as medical homes. The program includes nine standards for medical practices to meet, including use of patient self-management support, care coordination, and performance reporting and improvement.