Swedish opens “medical home” clinic in Ballard

This week Swedish Medical Center opens a new primary-care clinic that will use the medical-home model of healthcare delivery.

Swedish officials believe the clinic, which will be located at its campus in Ballard, is the first in the country to be designed from the ground up on the medical-home model.

The idea behind the medical-home model is to create a primary-care team that provides continuous, coordinated care to patients at one location so that patients do not need to scurry from doctor to doctor and specialist to specialist to have all their health problems addressed.

Proponents say the medical-home approach provides better care at lower cost than the often fragmented care most U.S. patients now receive.

Swedish CEO Rodney Hochman, M.D. talks about the new clinic:

Monthly fee: $45

Patients who enroll in the Ballard program, for example, will be allowed unlimited number of visits to the clinic’s physician teams and access to a wide range of primary-care tests and procedures for a monthly fee of $45 a month.

Dr. Mike Tuggy, medical director of the Family Practice Residency Program at Swedish/First Hill, calls it one of the best deals in medicine.

“For the cost of your monthly cellphone subscription, you can get health care,” Dr. Tuggy said.

The cost of enrollment for a family of two is $85 per month and $35 dollars for each additional family member.

Tuggy expects the program should be especially appealing for individuals and families who have high-deductible health insurance plans, which require costly co-payments for many basic services.

The monthly fees cover all visits, phone calls and email contacts, as well as all tests done in the clinic, which include standard office practice tests, such as blood sugar levels and PAP smears, and preventive care, such as vaccinations.

Visits: 30 to 60 minutes

Swedish promises that appointments will be scheduled the same day the patient calls or at the next day and that appointments will be 30 to 60 minutes long so that patients and physicians will have ample time to discuss problems and treatment plans.

There are no co-payments for visits or other services.

Enrollment, however, does not include radiologic tests, such as X-rays, emergency room visits, hospitalization or speciality care.

For this reason, the clinic urges all enrollees have some form of coverage to cover high-cost speciality and hospital care and a catastrophic illness.

The clinic’s care will be provided by two family-practice physicians, six family-practice residents, and a team of mid-level providers. Nurse-care managers will help patients communicate with the team and navigate the health-care system.

Online appointment scheduling

Patients will also have access to an online service called “MyChart” through which they will be able to view summaries of their medical records, schedule appointments, request prescription refills, and communicate via secure e-mail with the clinic’s health-care team.

The center also promises to have a physician available 24 hours a day, seven days a week for phone consultation.  Because medical records are online, the physician will have immediate access to a patient’s medical information even after hours.

The clinic’s team approach appeals to doctors because it gives them much more time to be with patients, says Dr. Jay Fathi, medical director of Primary Care and Community Health at Swedish.

In many primary-care practices, doctors are so pressed for time that they must limit visits to 7 to 9 minutes, Dr. Fathi says.

The team approach gets family physicians “off the appointment treadmill,” Dr. Fathi says, and allows them to spend more time with patients “face-to-face”.

Because patients pay a flat monthly fee for care, physicians have no incentive to schedule unnecessary visits, tests or procedures to increase their income, says Dr. Carol Cordy, the new clinic’s medical director.

Instead, the physicians can spend their time providing preventive care and managing their patients medical problems so they stay healthy and out of the hospital, Cordy says.

Subsidized care for low-income uninsured

In addition to self-paying patients, the clinic will see patients covered by Medicaid and Medicare and has an arrangement to enroll patients with coverage from Premera Blue Cross.

Insurers are willing to pay the monthly fees for their enrollees because studies have shown medical-home care significantly cuts insurers’ bills by preventing costly illnesses, emergency room visits and hospitalizations, says Dr. Tuggy.

The clinic will also provide subsidized care for uninsured, low-income patients whose family income is less than 200 percent of federal poverty level. For an individual, that would be $21,660 a year, and for a family of five, $51,580 a year.

To learn more:

• Call the Swedish Community Health practice: 206-297-5100
• Email the clinic: communityhealthballard@swedish.org
• Read a special report on the Medical Home Model prepared by the American Academy of Family Physicians.

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