A family physician reflects on the potential of primary care medical homes to partner with patients to reduce preventable mortality by helping them find and keep health insurance coverage, asserting that ensuring all patients have the best and most continuous coverage available to them under existing and newly expanded programs may be as (or more) important than ensuring all patients have optimal blood pressure control, diabetes control or timely cancer screenings. DeVoe outlines how basic tenets from the chronic care model can be operationalized to build systems that treat the United States’ large “uninsurance” problem. Primary care clinicians, she argues, are in a position to see how lack of insurance negatively affects health, and she calls for the development of effective processes and tools within the medical home to help patients obtain health insurance, retain their coverage or make important health insurance coverage decisions. Health care financing, she argues, should no longer be separate from the delivery of health care services. She concludes that by adopting uninsurance and underinsurance as a chronic illness, and applying the tenets and tools of the chronic care model to treat it, medical homes have the opportunity to improve population health and make a positive difference in the lives of patients.
Being Uninsured is Bad for Your Health: Can Medical Homes Play a Role in Treating the Uninsurance Ailment?
By Jennifer E. DeVoe, MD, DPhil
Oregon Health & Science University, Portland