Patient the center of medical focus

Medical providers in this part of Montana are providing a whole-person based health care system, with the Montana insurance and securities commissioner listing them as part of a new program approved by the 2013 Legislature.

Commissioner of Securities and Insurance Monica Lindeen this week listed 29 Montana health care providers qualified, and another 43 provisionally qualified, under Montana's Patient-Centered Medical Home Program.

"Medical spending goes up every year in this country, and it's time to do more than just talk about it," Lindeen said. "I am done talking. Patient-centered medical homes are shown to actually reduce costs. This program and the medical practices that have joined it are on the front lines of changing the way medicine is delivered in Montana."

The concept of patient-centered medical homes - often referred to as PCMH - is having a team of health-care professionals providing coordinated care including preventative and "wellness" medicine as well as treatment of illnesses or injuries and chronic ailments.

Lindeen's report lists Havre's Bullhook Community Medical Center as qualified under the 2013 act, and Chinook's Sweet Medical Center and Havre's Northern Montana Medical Group east and west as provisionally qualified.

Jennifer McKee, communications director for the commissioner's office, said the "provisional" listing means the facility is working toward meeting the requirements and is qualified under the state act as long as it continues to work toward qualification.

She said four national agencies accredit facilities as patient-centered medical homes, three of which meet the recently established Montana requirements.

McKee added that the Montana standards were set to a very high bar.

The benefit to the facilities is at least two-fold, she said.

Part of the benefit is having the same standards set for every institution, and every insurance company and program like Medicare and Medicaid. That means different companies won't have different requirements, or different payment schedules, for the same facility providing the same care.

The other is the benefit for the patients, she said.

"They can operate in this way that improves their patients' health, and they can be paid for it," McKee said.

The patient-centered model was part of Bullhook's push to build a new medical facility, bringing together all of its services under one roof. The health center now offers some mecical and counseling services in its facility rented just east of Northern Montana Hospital and dental services in a space in the Atrium Shopping Mall.

Bullhook CEO Cindy Smith said the new facility, being built across from Havre City Hall and the police and fire departments on the 500 Block of 4th Street, is expected to be open and operating by mid-July.

Smith said some of the focus in the patient-centered model is on improving behavioral health along with integrating and coordinating the treatment from different providers and specialists. It also includes feedback from the patient and the patient's family in improving the care - perhaps the most important component, Smith said.

Sweet Medical Center CEO Meghan Morris said the center staff is implementing new practices and procedures as it works through the application process for full qualification.

She added that the patient-centered concept is not new,

"It has always been our focus to provide holistic and comprehensive care," Morris said. "What PCMH does do, however, is provide a more structured framework for patients and providers to really engage as a team or partnership focused on overall health, with the healthcare providers acting as a quarterback working with an engaged and empowered patient - the team member - to navigate through a complicated healthcare system."

Christen Obresley of Northern Montana Health Care said Northern is working through the "152 clear and specific criteria that need to be met" under the National Committee for Quality Assurance requirements.

She added that the concept is included in a new facility Northern is building.

"The PCMH program heavily influenced the design of the new Northern Montana Family Medical Center which is under construction now,"Obresley said. "The new pod's design involves team work areas and collaboration spaces that promote communication."

Obresley said another important component is the Electronic Health Record for each patient that allows providers to track care and conditions over time, and added that Northern soon will be expanding that.

"Soon we will be introducing the patient portal to the community," she said, and will be asking for patient emails if they wish to be able to access some of their own records online.