A Look at Medical Home Nursing

As a medical home–management nurse, Jamie Jones is a pioneer in a healthcare model that is breaking ground itself.

“Medical home” is one of the hottest topics in healthcare. It’s spawning studies, think tanks – and new employment avenues for nurses and other primary care providers.

Value of medical homes

At its most basic, a patient-centered medical home is a structured way of managing chronic illnesses and diseases by making the patient the lynchpin of the “family.” Patients manage their illnesses or disease with regular and consistent visits to their primary care providers. That’s different from the traditional model of visiting the nurse or doctor only when they don’t feel good or need a new prescription.

Here’s the National Committee for Quality Assurance’s (NCQA) formal description of a medical home:

“A model of care that strengthens the clinician-patient relationship by replacing episodic care with coordinated care and a long-term healing relationship. Each patient has a relationship with a primary care clinician who leads a team at a single location that takes collective responsibility for patient care, providing for the patient’s healthcare needs and arranging for appropriate care with other qualified clinicians. The medical home is intended to result in more personalized, coordinated, effective and efficient care.”

According to a May 2011 report in The Online Journal of Issues in Nursing, the NCQA has defined clinical and service metrics for primary care providers seeking medical home certification. Those guidelines will help substantiate the value of the primary care providers.

Translated, it means the greater the value, the greater the compensation. “This is the first step in addressing the dwindling primary care workforce,” according to the report.

How nurses fit in

Nurses like Jamie Jones play key roles in how medical homes actually operate. “This job perfectly combined my knowledge of the disease processes with my experience and passion for education and training of patients and staff,” says Jones, patient-centered medical home-development nurse for Spirit Physician Services Inc. in Camp Hill, Pa. She works at family health centers within the Holy Spirit Health System.

For nurses and other primary care providers, the medical home concept is a way to bolster the need for your services. And, as nurses continue to complain about overtime and long hours, Jones says the regular weekday-only hours are a big plus.

There’s no certification in this field yet, but that may be coming. Jones holds a bachelor of science degree in nursing, and is experienced in coaching patients and their family members on the management of diseases or illnesses. She also trains other staffers. Her “typical” day goes like this:

• Visit one of three family health centers participating in the medical home program.
• Check in with staff to determine any specific needs.
• Review patient charts, enter them into Excel spreadsheets to track patient progress.
• Contact patients who may be overdue for visits.
• Meet with scheduled patients for education (could be diabetes counseling about carb-counting, meal-planning, label-reading or blood-sugar testing).
• Assist patients who can’t afford meds and help locate local programs for them.
• Meet with insurance companies who are medical home program participants.
• Prepare patient charts for physician review prior to visits (indicating labs, tests or vaccines that are due).

“Every day is different and each day could be split among multiple sites,” Jones says.

Medical home management nurses can earn from the $50,000s to $70,000s, depending on what kind of facility or practice they are in, she says.