To:   My Registered Dietitian & DTR colleagues who aren’t members of ADA

FROM: ADA

ADA Policy Initiatives and Advocacy Report

What you need to know about the Patient-Centered Medical Home

People are talking about the Patient-Centered Medical Home. It is in the news, it is in both the House and Senate health reform bills, it is even supported by the World Health Organization and yet there is little clarity on what the medical home is.

This week’s PIA Report aims to explain what the patient centered medical home is, discuss how health reform could solidify this type of care coordination and how you can get involved.

What is a medical home?

The Patient-Centered Medical Home is not home health care, but rather a new term for an innovative kind of disease management. The goal is to move away from the current system where patients do not understand their diagnosis and are disconnected from their care.

It is care coordinated by a primary physician. The physician and his or her staff organize personalized treatment for a patient with other providers – registered dietitians, physical therapists, oncologists, gynecologists, etc. – whom the patient might see.

The medical home creates a stronger relationship between patient and physician by focusing on long-term health outcomes as well as putting more responsibility in the hands of the patient.  It also encourages the physician to make referrals to appropriate providers for preventive services.

What is in the Senate and House health reform bills?

Senate: Patients Protection and Affordable Care Act:

• MEDICAID: Allows for medical home waivers for state-coordinated programs that focus on diabetes treatment and prevention, treat cardiovascular disease and treat those considered overweight. Nutritionists are listed among providers under this program, allowing for inclusion of RDs.
• COMMUNITY: Establishes the medical home in public health programs and includes the registered dietitian as part of the medical home team.

House: Affordable Health Care for America Act

• Establishes both community-based and individual-based medical home pilot programs that are to be led by a primary physician or a nurse practitioner who then will coordinate with other non-physician practitioners in chronic care management activities such as: managing chronic illnesses, transitional care services, care plan setting and nutritional counseling.

What is ADA doing and how can you get involved?

The medical home model has a lot of support in Congress and in the federal and state governments. Get involved now to help ensure RDs and DTRs are included in future programs.

The American Dietetic Association is just one of many groups working to improve and promote the medical home; our goal is to highlight the importance of the health care team who will participate in the care of the patients.

ADA’s Health Care Reform Task Force identified five tenets for ADA to use to analyze any health reform package before Congress. The fifth tenet states that “health care must be patient-centered” identifying coordinated care as the best way to deliver care and ensure best health outcomes.

In March, ADA created a Medical Home Workgroup that was charged with collecting information about the current role of the registered dietitian in the medical home and then to develop a strategic plan to engage dietitians in the system. In May, the workgroup completed its work and submitted an official report and strategic plan to the House of Delegates for its Fall meeting.

Your role is significant. Physicians managing medical homes will want to know who the other providers in their area are. You can do this by reaching out to them and promoting your services.  In addition, ADA’s new Website, set to launch on December 7, will contain a page for other providers to help them locate an RD or DTR in their area.

You can and should get involved to ensure you are properly represented in any reform measures that are adopted by Congress. Even if Congress is unable to pass sweeping reform in 2010, there are still opportunities for you to participate in the medical home.  Contact your Public Policy Coordinator or State Policy Representative to learn more about actions taking place in your state or ADA’s Washington, D.C. office about what is occurring in Congress and at the regulatory level.