Medical Home

Indicator Definition
Adults (ages 18–64 years) who report having one or more individuals they think of as their personal doctor or health care provider.

Adults with a regular source of medical care in Colorado4

Adults with a regular source of medical care by sex in Colorado5

Indicator Significance
An increasing number of uninsured Americans report not having a regular source of medical care because of their inability to pay for medical-related expenses. Adult preventive screenings such as mammograms and colonoscopies are twice as likely to occur if an individual has a regular source of medical care. Foregoing routine medical care and preventive screenings often leads to an increased incidence of preventable illnesses and costlier treatments. Recent research has shown that having “medical homes,” particularly for vulnerable population groups, is a cost-effective means to reduce health disparities. Adults with access to a regular source of medical care also are better able to better manage chronic illnesses.¹

Colorado Specifics 
Roughly one-quarter of working-age adults in Colorado report having no one they think of as their regular health care provider. Most states do better than this, though no state has reached the Healthy People 2010 target of 96 percent. Colorado’s poor showing is partly explained by the relatively high proportion of uninsured working-age adults. Both the uninsurance rate and the proportion of adults lacking a regular source of care have remained stable for several years. Women are more likely than men to have a regular source of medical care.

Promising Initiatives
In Colorado
The Marillac Clinic serves Mesa County’s low-income and uninsured residents. Marillac is a fully integrated and comprehensive primary care clinic offering mental health, social, dental and physical primary care to both uninsured adults and children. Prevention and early intervention are at the foundation of Marillac Clinic services, where no-cost labs and sliding fee x-rays are performed at the St. Mary’s Hospital, on whose campus Marillac is located. No one is denied care at the clinic, although patients are expected to pay for some portion of their visit using a sliding fee schedule based on family income.²

Elsewhere
Healthy San Francisco is a new initiative begun in April 2007 to provide coverage to the city’s 82,000 uninsured adults. The goal is to provide a medical home to uninsured adults, not act as an insurance program. Healthy San Francisco provides funds to strengthen the city’s safety net, which includes 20 clinics and a public hospital. To fund the program, employers with 20 or more employees are mandated to pay a minimum fee of $1.17 an hour for workers’ health care. All uninsured city residents are eligible if they are ineligible
for other government programs. As of September 2008, there were 29,000 people enrolled in the program.³

Adults with a regular source of medical care⁶

Text

1. Program on Health Outcomes. "Quality of Health Care in the United States: A Chartbook"; April 2002.
   
   The Commonwealth Fund. “Disparities in Health Care Are Driven by Where Minority Patients Seek Care”; June 25, 2007.
   
   
2. Marillac Clinic.
   
3. Healthy San Francisco.
   

Charts

4. Source: Colorado Department of Public Health and Environment and Colorado Health Institute analysis of Behavioral Risk Factor Surveillance System, Centers for Disease Control and Prevention 2000–2007.
   
5. Source: Colorado Health Institute analysis of Behavioral Risk Factor Surveillance System, 2007, Centers for Disease Control and Prevention.
   
6. Source: Colorado Health Institute analysis of Behavioral Risk Factor Surveillance System, 2007, Centers for Disease Control and Prevention.