If you have inflammatory bowel disease (IBD), Crohn’s disease or ulcerative colitis, you know how difficult, expensive and frustrating it can be to get the care you need. But there’s a new approach to treatment—involving a radical change in who acts as your primary care provider—that might soon be available to you.
Called a “patient-centered medical home” for IBD, it’s not a place, but rather an approach to care, centered on you. Under this treatment protocol, you work with a team of medical professionals, as well as tap into remote monitoring for check-ins, often through a smartphone app and video telecommunication (telehealth), to cut down on the number of office visits you need to make. Health insurance providers who participate in this type of service contract directly with the doctor who will be leading your care team and pay a lump sum for your care so that you don’t need to file claims for each individual service.
One unique part of this model is that your gastroenterologist serves as your principal health-care provider. That enables you to get specialized care as your everyday care. Studies show that this single change in IBD management helps avoid many of the emergency room visits and hospitalizations—and their financial and emotional costs—associated with IBD.
Other members of your medical team include a nurse practitioner to educate you about your disease and preventive health strategies, a dietitian who addresses your unique nutritional needs, a mental health provider to help you manage the emotional impact of IBD and a social worker to help you access any other types of care you might need such as home visits from nurses and the remote-monitoring options. The patient-centered medical home concept was originally developed to provide a better level of care through primary care doctors and pediatricians. It has since been adapted for chronic diseases such as diabetes, and extending this model to IBD seems like a natural fit.
How can you avail yourself of this care? At the moment, the IBD patient-centered medical home is such a new concept that it’s available at only a handful of places. It was pioneered at University of Pittsburgh Medical Center (which has an ongoing program for patients in its network), is also offered at several gastroenterology practices in Illinois and is under development at Cleveland Clinic. As insurers come to appreciate the benefits for patients’ health and their own bottom lines—because this type of care cuts down on emergencies and expensive hospital visits—the hope is that the model will grow in IBD care as it has with other conditions.
If there’s no IBD medical home model in your area and you’re currently getting uncoordinated care from different providers, find out whether there is a medical center near you with a dedicated IBD program, often called an IBD Center of Excellence. (Google that term or visit the website of the Crohn’s and Colitis Foundation for tips to locate a treatment center near you.) If you aren’t near a large medical center, your doctor may be able to connect with one. Most insurance companies will cover visits to IBD Centers of Excellence and the resources that these centers provide.