Our Model of Care

Patient-Centered Medical Home

Circle Health Services is transitioning to a new model of health care called the Patient-Centered Medical Home. A Medical Home is not a house, office, or hospital, but rather an approach to providing comprehensive and individualized primary care. In a Patient-Centered Medical Home you will be a part of a team made up of providers, medical assistants and health specialists that help coordinate your health care.

What is a Patient Centered Medical Home?

A patient centered medical home is a place where you can go to receive excellent healthcare, from a team of professionals who work with you to ensure that your needs are met, your voice is heard, and your health and well-being is at the center of our practice. In the medical home, care is evidence based, accessible, well-coordinated and patient focused. Patient satisfaction and quality of care are of the utmost importance. We want you to feel at home and well cared for by your health care team and most importantly we want you to meet your healthcare goals.

Why is it important to have a primary care provider?

Your primary care provider (PCP) is the central resource for healthcare and health information. Not only do they provide preventive and general healthcare, they are your healthcare guide and advocate, directing you to specialists and helping you navigate the healthcare system to ensure you receive the medical care you need.

How do I choose a primary care provider?

Patients are provided with options in choosing a primary care provider based on personal preference, medical needs and provider expertise. At our health center patients have access to adult and pediatric primary care practitioners, behavioral health providers and dental professionals. The health center providers are all board certified, with significant expertise and experience in their field of study. As a medical patient you have the choice between a MD and a Nurse Practitioner. To learn more about our providers and to receive help selecting your own primary care provider, call 216-707-3434.

How is care coordinated across the health center and with outside specialists?

Care coordination begins with your primary care team, which consists of you, your provider, medical assistant, care manager, and nurse. Your team is required to understand you, understand family dynamics, unique needs, your values and preferences, even your cultural orientation and background. Depending on your needs, other members of the team may include medical specialists, mental health and substance abuse providers and/or clinical pharmacist(s). Your primary care team is actively involved in working to provide you with the best care possible by accessing different disciplines in the health center and outside. Your care team works closely with local hospitals, off-site specialists and community resources to ensure that we meet the needs of our patients and we provide timely and accurate follow through. Most importantly, the success of the Patient Centered Medical Home model depends on keeping you informed and engaged in your treatment and providing you with the supporters necessary to manage your own health the way it makes sense to you and your family.

How do I get specialty care?

We provide our patients with specialty services such as podiatry, ophthalmology, physical therapy, HIV treatment, primary care and care management. For all other specialty care needs, your care team has access to specialty services in the communities we serve.

How do I get involved in my treatment plan?

Engaging you in your treatment plan is the core of Patient Centered Medical Home. We will involve you in a variety of ways: the care team will ask for your input about medical decisions and treatments, will work with you to develop self-management goals and care plans will ask you for feedback in the way of patient satisfaction surveys and focus groups and will provide you with access to resources to support your medical care.

How do I get a referral? How does the center ensure that the referral is obtained and report received?

The best way to obtain a referral is to schedule an appointment with your provider so that this can be done in a more informed and efficient manner. After consulting with your provider, a mutual decision is made to refer you for diagnostic testing or specialty care depending on your needs. Your provider will make a referral to the referral team and the referral team will work with your insurance company to ensure that the services you’ve been referred to is approved by your insurance agency and to schedule an appointment.

How do I get a referral? How does the center ensure that the referral is obtained and report received?

You have several options to choose from including making calls to your team, scheduling and appointment to see your provider and have a face to face discussion of any issues that are relevant to you and your treatment, using MyChart to communicate via secure email. If you are not enrolled in MyChart, we encourage you to speak with your care team on how to obtain a user name and password. An on-call provider is available to provide clinical advice to existing patients after-hours, on weekends and during holidays when the health center is closed. For detailed information about health center services, hours of operation and phone numbers, click here.

 

How Can You Be An Active Partner?

Talk to Us

Give us feedback on how our office works by filling out a comment card. You may be asked to complete a patient experience survey at your next visit. If you have ideas for how we can improve our services, please consider joining our Patient Advisory Committee.

Keep Us Informed

We function most effectively as your medical home when you provide us with a complete medical history, including any recent visits to other providers, recent hospitalizations, tests or Emergency Department visits since your last appointment with your health center provider.

Take Care of Yourself

Set health goals that you are comfortable with and make life choices to meet those targets. Join support groups with people like you and learn how to manage serious illnesses. Ask your care team for more information about available support, education and therapy groups.

Be Safe

Look at different treatment options and compare their risks and benefits. Tell your provider about any medicines, supplements and herbal or holistic products you take.

 

Resources

A copy of our patient wallet card is depicted below. Ask your provider for your own card. Click to see our Patient Brochure.

Free-Clinic-Patient-Card-1Free-Clinic-Patient-Card-2