Medical Home in Nebraska

Nebraska

The medical home model was developed by the American Academy of Pediatrics to promote information exchange, improve quality and cultural competence of care and increase continuity of care among children and adolescents.

Children both with and without special health care needs who receive care in a medical home model experience better outcomes than children receiving care in non-medical home settings. Children with special health care needs outside of a medical home setting are nearly three times as likely to have unmet health care needs as those who receive care within a medical home. Those without special health care needs are nearly twice as likely compared with similar children who receive care within a medical home.

Populations of children who have higher rates of attaining care that meets medical home criteria include:

• Younger children ages 0-5 compared with older children ages 12-17. 
• Non-Hispanic white children compared with Hispanic, non-Hispanic Black and non-Hispanic Asian children.
• Children who speak English at home compared with children who speak a language other than English at home.
• Children who have insurance coverage compared with children who are uninsured.
• Children from higher-income families compared with children experiencing poverty. 
• Children whose parents have higher educational attainment compared with children whose parents have a high school education or below.

Strategies to expand medical homes among children include: 

• Prioritizing underserved racial and ethnic minority communities and providing financial incentives to address health disparities. 
• Factoring the relationship between a patient and their physician into the accreditation process.
• Building care coordination that involves educational and community resources to promote healthy development among children in medical homes. 
• Increasing research into effective medical home models, specifically for children. 

Healthy People 2030 has an objective to increase the proportion of children and adolescents who receive care in a medical home.

Akobirshoev, Ilhom, Susan Parish, Monika Mitra, and Robbie Dembo. 2019. “Impact of Medical Home on Health Care of Children With and Without Special Health Care Needs: Update from the 2016 National Survey of Children’s Health.” Maternal and Child Health Journal 23 (11): 1500–1507. https://doi.org/10.1007/s10995-019-02774-9.

Bachrach, Andrea, Elizabeth Isakson, David Seith, and Christel Brellochs. 2011. “Pediatric Medical Homes: Laying the Foundation of a Promising Model of Care.” New York: National Center for Children in Poverty. https://www.nccp.org/wp-content/uploads/2020/05/text_1041.pdf.

Hadland, Scott E., and Webb E. Long. 2014. “A Systematic Review of the Medical Home for Children Without Special Health Care Needs.” Maternal and Child Health Journal 18 (4): 891–98. https://doi.org/10.1007/s10995-013-1315-9.

Homer, Charles J., Kirsten Klatka, Diane Romm, Karen Kuhlthau, Sheila Bloom, Paul Newacheck, Jeanne Van Cleave, and James M. Perrin. 2008. “A Review of the Evidence for the Medical Home for Children With Special Health Care Needs.” Pediatrics 122 (4): e922–37. https://doi.org/10.1542/peds.2007-3762.

Medical Home Initiatives for Children With Special Needs Project Advisory Committee. 2002. “The Medical Home.” Pediatrics 110 (1): 184–86. https://doi.org/10.1542/peds.110.1.184.