Alaskan "Medical Home" Approach

A recent piece in the Anchorage Daily News highlights some health care successes worth noting. Southcentral Foundation serves the medical and other needs of Alaska Natives. Its network includes a primary care clinic and some specialty services and it jointly runs the Alaska Native Medical Center with the Alaska Native Tribal Health Consortium.

Southcentral's approach is one version of the "medical home" model that is said to have piqued the interest of members of the Obama administration. It is a “comprehensive” approach to health care which distinguishes acute and traumatic maladies from chronic conditions. The Southcentral system is premised on the belief that the “mechanical-repair model” (it’s broke, let’s fix it with a procedure and/or medication) “is great if you are in an accident and need trauma care….But the vast majority of health care deals with chronic conditions and the fallout from behavioral choices people make.”

For these chronic issues, Southcentral offers a team which “includes a doctor, nurse, and case manager, as well as access to a nutritionist, traditional healers and a behavioral counselor,” and “follow-up services – pharmacy for drugs, labs for testing – are right on the same campus, making access easy.” Southcentral's Karen McIntire has stated that “70 percent of primary care does not require a doctor,” and that “In our system, who you see depends on what you need." The Anchorage Daily News reports that “With this comprehensive approach, Southcentral reports major changes for the better. Writing in the January 2008 issue of Family Practice Management, CEO Gottlieb reported that emergency room and urgent care visits have dropped by more than 40 percent, while use of specialists fell 50 percent and the number of hospital days shrank by 30 percent.” Read full story here.