Patient Centered Medical Home

Welcome to Your Patient-Centered Medical Home

What is a Patient-Centered Medical Home

The Central North Alabama Health Services, Inc. (CNAHSI) Health Care System is proud to be a Patient-Centered Medical Home (PCMH)! The PCMH initiative is a new way of managing your health care.

A Patient-Centered Medical Home is a system of care in which a team of health professionals works together to provide all of your healthcare needs. We use a team approach to communicate and coordinate your care and provide the best possible outcomes for you.

You, the patient, is the most important part of the Patient-Centered Medical Home. When you take an active role in your health and work closely with us, you can be sure that you are getting the care you need.

We are excited to introduce this Model of Care, as we strive to improve the quality of care for you and your family!

Your Team

Once you choose a primary care provider, you will be assigned to a team of dedicated healthcare professionals who work together to meet all of your individual needs.

What to Expect from your Team!

Primary Care Provider

  • Explains medical care and medication in an easy way to understand
  • Listens to your feelings and questions about your health
  • Arranges for needed additional testing or evaluation

Nurses/Medical Assistants

  • Gather basic health information for visits
  • Patient education, health promotion, and basic assistance management
  • Handle phone calls and urgent inquiries
  • Coordinate delivery of test results

Receptionist/Records Staff

  • Patient reception
  • Update demographics/contact and insurance information

Case Managers/Patient-Centered Medical Home Specialists

  • Basic case management
  • Coordination of preventive care for all patients
  • Coordination of care for internal and external
  • Referrals

5 Components of Patient-Centered Medical Home

Comprehensive Care:

Care that is designed to meet the majority of a patient’s physical and mental health care needs through a team-based approach to care.

Coordinated Care:

Care that coordinates patient care across all elements of the healthcare system, such as specialty care, hospitals, home healthcare, and community services, with an emphasis on e_cient care transitions.

Accessible Services:

Making primary care accessible through minimizing wait times, enhanced o_ce hours, and after-hours access to providers through alternative methods such as telephone or email.

Patient-Centered Care:

Partnering with patients’ families through an understanding of and respect for culture, unique needs, preferences, and values.

Quality and Safety:

Committed to providing safe, high-quality care through clinical decision-support tools, evidence-based care, sharing decision-making, performance measurement, and population health management.

Join The Team!

Ultimately, we want to help you take responsibility for your health. You are the most important part of your healthcare team. Your team can only make recommendations; the power to decide if you will follow them is yours. So as part of your healthcare team, I hope you will share the team’s goal: to give yourself the best care possible. It is not difficult, but it is important. Here are some things you can do:

  • Communicate with all members of your care team about your health and needs.
  • Come to each visit with any updates on medications, dietary supplements, or remedies you are using, and questions you may have.
  • Keep scheduled appointments or call to reschedule or cancel as early as possible.
  • Understand your health condition: ask questions about your care and tell us when you do not understand something.
  • Follow the plan that we have agreed is best for your health.
  • Contact us after-hours only if your issue cannot wait until the next workday.
  • If possible, contact us before going to the emergency room so someone who knows your medical history can care for you.
  • Let us know if you do not receive your test results within two weeks.
  • Offer any feedback you might have to help us improve our care.

March 2023

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Patient Centered Medical Home

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