Legislation could benefit new Havre medical center, director says

Work by the state's commissioner of securities and insurance is going hand-in-hand with plans to expand the community health center in Havre, with Bullhook Community Health Center Executive Director Cindy Smith saying legislation requested by the commissioner could benefit the operations of a new facility expected to open in the spring of 2014.

Montana Auditor Monica Lindeen, the state commissioner of securities and insurance, requested Senate Bill 84 in this year's Legislature to provide state oversight of the relationship between insurers and health care providers as more providers move toward what is called a "patient-centered medical home" model.

Lindeen also announced that assistance for the nonprofit National Academy for State Health Policy will help Montana and three other states, Nebraska, Pennsylvania and West Virginia, establish use of the model.

"Patient-centered medical homes can be a solution to the rising costs and limited access issues that plague our health care system, " Lindeen said in a release. "Getting health insurers, public programs, and health care providers working together isn't always easy, but I believe a market-driven approach is the best way to make effective, enduring improvements to health care in Montana. "

The term "patient-centered medical home" was first coined in 1967 by the American Academy of Pediatrics. It was designed as a way to approach medical care for children, particularly children with special needs who needed coordinated care.

The concept is to have a team working together to create a coordinated treatment for a patient, including preventative care and wellness programs.

Lindeen started work on increasing use of the model in Montana shortly after she was first elected auditor in 2009. She facilitates the work of the Montana Patient-Centered Medical Home Advisory Council, which includes insurance company representatives, medical providers and consumer advocates who are working toward advancing the concept of patient-centered medical homes in Montana.

Blue Cross and Blue Shield of Montana also has been spearheading a movement toward the model's use in Montana, developing a program in 2011 for patient-centered medical home model facilities.

Lindeen said the assistance from the National Academy for State Health Policy award will give Montana access to national experts, federal officials and a state mentor to help Lindeen continue to develop Montana's patient-centered medical home model. The program begins with a kick-off meeting in March and lasts for 18 months.

Representatives from Lindeen's office, Montana Medicaid, Bozeman Deaconess Health Group, and Blue Cross Blue Shield of Montana will participate.

Bullhook, which is working with Lindeen's effort, is moving toward breaking ground this spring on a new facility on the corner of 5th Avenue and 4th Street, across from Havre City Hall, with the intent of creating a patient-centered home model of care in the facility.

Smith said that a patient-centered model provides the best way to care for Bullhook patients, and the community health center has been working toward using the model.

"The care we provide includes prevention, education, counseling, medical care, dental care and care management …, " she said. "The new building, changing the delivery of care and adding teams and care coordination to support the health provider, and continually striving to improve everything we do for care and patient experience of care helps to break down the barriers. "

Bullhook also is part of a U. S. Department of Health and Human Services Health Resources Service Administration initiative to promote the patient-centered medical home model. Smith said the model fits well for community health centers. Having medical and dental care and addiction counseling as well as a pharmacist and mental health provider under the same roof could help find the best options and plans for health care, she said.

"Many times, a patient's care involves all of these disciplines or just some of them, but it is easier and better for the patient if everyone is working toward the same goals, " Smith said. "The patient has an easier time navigating the system and giving his or her input to how the medical plan or treatments work for them. Prevention is a top priority. "

Dave Henry, president and CEO of Northern Montana Healthcare, said Thursday that Northern is working with Blue Cross Blue Shield on its statewide project.

Jared Payne, executive director of the Sweet Medical Center in Chinook, said that facility also is moving toward a patient-centered medical home model, and expects to be recognized by next fall as such under current standards

Emailed requests for comments from Liberty Medical Center in Chester had not been returned by the Havre Daily News deadline this morning.

Smith said passing SB 84 could help prevent problems raised by moving to that model. Without oversight, different insurers might set up multiple and different requirements and procedures that could cause complications and could affect payments for some services, such as preventative care.

"If the bill does not pass, it may put some extra burden on Bullhook …, " she said. "I also believe that if it does not pass then there may not be a statewide commitment to a good model of care. "

Online: Montana Patient Centered Medical Home Initiative webpage, Montana commissioner of securities and insurance website: http://www.csi.mt.gov/medicalhomes/index.asp