Foundations, government, and the health care sector are making large investments to reengineer and revitalize primary care, hoping this will improve the cost and quality of health care overall. Primary care practices that use expanded teams to deliver well-coordinated care designed around the needs of patients and families—widely known as patient-centered medical homes—have become the base of this movement.
For these investments to be successful, we at the John A. Hartford Foundation think it is important to target our efforts where these care innovations can reap benefits large enough to make a meaningful difference. The older adult population, with complex needs and higher costs than younger people have, represents the biggest orchard of low-hanging fruit out there. That is why we continue to invest in testing and spreading models of primary care for older adults that incorporate geriatrics expertise. However, we also think we can do as much as we want to and for this (or any) population, but without their input and involvement, we will fail.
To begin incorporating the input of older adults into the current debate about medical homes, we recently released our latest public opinion poll, “On Your Team.” We asked adults age sixty-five and over about their experiences with the expanded team and enhanced services offered through this type of primary care. This survey of 1,107 older adults was conducted January 30 through February 3, 2014, by PerryUndem Research/Communication using Knowledge Network’s nationally representative online panel.
Given the mixed results of medical home studies thus far (supported by many of our colleagues in philanthropy such as the Commonwealth Fund), we think this survey adds to our understanding of this evolving model’s potential benefits and points to the areas of greatest importance to the older patients we are trying to serve.
Through this poll, we heard an important message. Contrary to stereotypes that older adults distrust and resist changes to their health care and don’t trust anyone but their own physician, older adults value team care and other medical home services. Older adults want access to care when they need it (for example, same-day appointments, twenty-four-hour telephone access), coordination between their primary and specialty care providers, and a primary care team (including nurses, social workers, mental health providers, and others) all working off of a plan of care based on the individual patient’s own health goals.
While relatively few older adults receive this type of team care (just 27 percent), an overwhelming majority (83 percent) of those who do receive it report that it has made a difference in improving their health. Even among the many respondents who don’t receive team care now, a substantial majority (73 percent) say they would like to. Also, 61 percent say they believe this type of care would improve their health. About half (48 percent) of respondents who do not currently receive team care say they would change providers if it meant they could get such care. And as the number of medical home services that people received increased, so did their reported level of satisfaction with their care. Read the rest of this entry »