Medical Homes ( preferably “Health Home”) and the Uninsured

  • Nancy J. Johnson


Michelle entered the evening Free Clinic in the church basement to see someone about her earache. For the past 3 days, the pain in her ear had gotten worse, especially after working all day. Without any health insurance, the emergency room was too expensive and getting an appointment at a doctor’s office in the evening was impossible. The volunteer nurse practitioner checked her ears, listened to her chest, and gave her an antibiotic with enough pills for the needed ten day course. Michelle left her donation of $5 for the help. Fortunately, her ear pain resolved over the next week, but she continued to have a cough and felt like she was running a fever. She called a community health center but was unable to get an appointment that day as a new patient. At work, the next day, she felt exhausted and fainted while putting away supplies. Her boss took her to the emergency room, where she was examined, had a chest x-ray which diagnosed pneumonia, and was sent home with antibiotics and an order for at least a week in bed. Unfortunately, she was also sent home with a bill of over $800 and discharge instructions to follow up with her regular doctor. Michelle did not have a “regular doctor” – or a “medical home” for help with preventive health behaviors or acute health problems.


Medical Home Community Health Center Preventive Screening Commonwealth Fund Regular Doctor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abelson R (2009) United Health and IBM test health care plan. The New York Times. February 7, 2009Google Scholar
  2. Access across Vermont plan (2009) Available at Accessed 1 Apr 2009
  3. American Academy of Family Physicians (2009) Available at 20 March 2009
  4. American Academy of Pediatrics (2009) Available at Accessed 1 Mar 2009
  5. American College of Physicians (2009) Available at Accessed: March 1, 2009
  6. Backer LA (2007) The medical home: An idea whose time has come….again. Fam Pract Manag 14:38–42Google Scholar
  7. Berwick D (2002) Crossing the quality chasm: a new health care system for the 21st century. Available at Accessed 1 Mar 2009
  8. Blue Cross Blue Shield of Michigan (2009) Patient-centered medical home initiative plan for coordination of care. Available at Accessed 1 Apr 2009
  9. Bodenheimer T (2008) Coordinating care-A perilous journey through the health care system. N Engl J Med 358(10):1064–1071Google Scholar
  10. Commonwealth Fund (2007) Closing the divide: How medical homes promote equity in health care: Results from the Commonwealth Fund 2006 Health Care Quality Survey. Accessed 1 Apr 2009
  11. Community Care of North Carolina (2009) Available at Retrieved 1 Apr 2009
  12. Grumbach K, Bodenheimer T (2002) A primary care home for Americans: Putting the house in order. J Am Med Assoc 288:889–893CrossRefGoogle Scholar
  13. Guidelines for a Medical Home (2009) Available at Accessed 3 Apr 2009
  14. Healthy People 2010 (2009) Accessed 24 Feb 2009
  15. Homer CJ, Klatka K, Romm D, Kuhlthau K, Bloom S, Newacheck P, Van Cleave J, Perrin JM (2008) A review of the evidence for the medical home for children with special health care needs. Pediatrics 1222(4):922–937Google Scholar
  16. Kaiser Commission on Medicaid and the Uninsured: Healthy San Francisco (2009) Available at Accessed 31 Mar 2009
  17. McAllister J, Presler E, Cooley WC (2007) Medical home practice-based care: A workbook. Center for Medical Home Improvement, Greenfield, NHGoogle Scholar
  18. Medical Home Demonstration Project (2009) Available at Accessed 1 Mar 2009
  19. Moore G, Showstack J (2003) Primary care medicine in crisis: Toward reconstruction and renewal. Ann Intern Med 138:244–247PubMedGoogle Scholar
  20. Murphy J, Chang H, Montgomery JE, Roger WH, Safran DG (2001) The quality of the physician–patient relationships: Patients’ experiences: 1996–1999. J Fam Pract 2001(50):123–129Google Scholar
  21. National Association of Community Health Centers (2009) A nationally recognized discharge planning program: Linking inmates with a medical home. Presented by Diana Lapp, Policy Institute, Washington, DCGoogle Scholar
  22. National Medical Home Summit (2009) Available at Accessed 3 Apr 2009
  23. Patient-Centered Primary Care Collaborative (2009) Available at Accessed 31 Mar 2009
  24. Physicians Practice Connections (2009) Available at Accessed 3 Apr 2009
  25. San Francisco Community Clinic Consortium (2009) Available at Accessed 3 Apr 2009
  26. The Future of Family Medicine Project (2004) Available at Accessed 3 Apr 2009
  27. TransforMED (2009) Available at Accessed 1 Mar 2009

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Nancy J. Johnson
    • 1
  1. 1.El Rio Community Health CenterTucsonUSA

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