Many of the nation’s health reform efforts center around the establishment of health care homes, which has been defined as “an approach to provide patient care that is accessible, comprehensive, family-centered, coordinated, compassionate, and culturally effective. With ICSI’s goal of helping to transform the health care system so it delivers patient-centered and value-driven care, the ICSI board of directors adopted health care home as a strategic initiative in 2008.

ICSI first explored the health care home concept as it existed in Minnesota in mid-2008. Through a health care home forum it hosted, ICSI discovered that stakeholders were interested in working together to further define and advance the concept of health care homes, that there were many points of commonality among current health care home efforts, and that there was much common ground upon which to build and learn from one another.

Health Care Home Steering Committee
ICSI next formed a Health Care Home Steering Committee, which is comprised of representatives from Minnesota provider groups, payers, purchasers, patients, academia, and government agencies. This group is working through ICSI’s proven collaborative process to that is patient-centered, comprehensive and coordinated, and that includes all parts of the community and health care system to provide care for all people from birth to death. A key goal is to create a model that is widely adopted by providers, supported by health plans and purchasers, and used by patients who stand to benefit from its availability.

Initial Work
The steering committee used the principles of the patient-centered medical home endorsed by the American Academy of Family Practitioners, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association as a starting point for its work. Collaboratively, committee members are focusing on developing care delivery models, and the financial and measurement models needed to support and sustain their use, plus broadly engaging stakeholders across the state to assure that these models are robust and the process is transparent.

Committee Actions
The ICSI Health Care Home Steering Committee has developed a charter and scope of work for the initiative, and is creating subgroups to address barriers to establishing a successful health care home. These include subgroups to:

• Look at payment/funding models that would work with integrated health care systems, smaller clinics and urban/rural communities
  
• Address the technical and cultural changes brought by a health care home to provider organizations
  
• Determine the connectivity between health care homes and specialty medical groups
  
• Determine patient expectations from a health care home.

ICSI has also established a social network of other local and national organizations working on their own health care home initiatives. The intent is to share approaches to enhance everyone’s health care home efforts and get to successful models faster.

State Health Care Reform
In addition to these ICSI-specific activities, ICSI is supporting the efforts of the Minnesota Department of Health Minnesota Department of Human Services to develop a health care home model as mandated by 2008 Minnesota Legislation.

ICSI was awarded a contract from these state organizations to develop the recommended health care system and patient outcomes that should be considered in the evaluation of health care homes. It convened a work group comprised of representatives from provider groups, health plans, purchasers, patients, academia, and government agencies to develop an evidence- and consensus-based list of health care home outcome recommendations.

The ICSI Health Care Home Steering Committee contributed to the process by reviewing all of the work group’s recommendations as well as stakeholder feedback to the recommendations, and by certifying that all stakeholders’ comments had been addressed adequately.

These outcomes have become an endpoint upon which the State is subsequently developing measurement, criteria for certification and other activities around the establishment of health care homes.