Medical Home - Children in Vermont

Vermont

The American Academy of Pediatrics developed the medical home model to promote information exchange, enhance health care quality and cultural competence, as well as increase continuity of care among children and adolescents. Medical homes provide preventive care, specialty care, educational services and family support, all of which help facilitate a sense of trust and partnership among physicians, patients and their families. A medical home does not refer to a specific building or place; rather, it is the partnership between the family, medical professionals and community resources.

All children 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 who receive care outside of a medical home setting are almost three times as likely to have unmet health care needs compared with those who receive care within a medical home, and children without special health care needs are still twice as likely to have unmet health care needs compared with their peers in medical homes.

According to America’s Health Rankings analysis, the prevalence of receiving care that meets medical home criteria include:

• White and multiracial children compared with Hawaiian/Pacific Islander children. The prevalence is three times higher among white children compared with Hawaiian/Pacific Islander children.
• Children with a parent or guardian who graduated from college compared with those whose parents or guardians have less than a high school education. The prevalence increases with each increase in education level.
• Children without special health care needs compared with children with special health care needs.

Additional research finds populations with higher rates of receiving care that meet medical home criteria include:

• Children who speak English at home.
• Children who have insurance coverage.
• Children from higher-income families.

Strategies to expand the adoption of the medical home model and improve health care quality for children include: 

• Prioritizing underserved racial/ethnic minority communities and providing financial incentives to address health disparities. 
• Incorporating 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. 

The National Center for Medical Home Implementation has developed a guide with strategies and interventions that work to enhance the effectiveness of medical home models. This guide incorporates all seven components of a medical home: accessible care, family-centered care, continuous care, comprehensive care, coordinated care, culturally effective care and addressing challenges with corresponding resolutions.

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. “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, no. 11 (November 1, 2019): 1500–1507. https://doi.org/10.1007/s10995-019-02774-9.

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

Chavdar, Müge, and Joan Jeung. A Collection of Strategies Used to Support Innovative and Promising Practices in Pediatric Medical Home Implementation. National Center for Medical Home Implementation, April 2018.https://downloads.aap.org/AAP/PDF/Medical%20Home/Promising%20Practictices%20Summary%20Report%20FINAL.pdf.