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HomeHealth ServicesPreventive CareHealth and WellnessMedical Home Port

Health Services

Medical Home Port

What is Medical Home Port?

Medical Home Port (MHP) is the name of your primary care clinic – the place where you go to see your health care provider (a doctor, nurse practitioner, or physician assistant) for annual check-ups, when you’re feeling sick, or when you’re injured.

Typically, you’ll find that a Medical Home Port clinic provides primary care that focuses on either:

  • Pediatrics (general pediatrics or adolescents)
  • Internal Medicine (adults)
  • Family Medicine (the whole family, ages 0-99 and older)

MHP’s goal is to work with you to keep you as healthy as possible by providing safe, high quality health care, focusing on you as a whole person, improving satisfaction with your care, and providing preventive care and early intervention to help you manage any health problems. MHP supports your health by:

  • Practicing patient-centered care.
    This means that you, not the illness or injury, are the focus of your provider and MHP team. Your care will address any recent illnesses or injuries as well as any underlying medical concerns. Your MHP team will make sure that you have the information and resources to help you manage your overall health and well-being.
  • Providing continuity of care.
    “Continuity of care” is an important MHP goal and it means that you see a provider that you know and who’s familiar with your medical history. To do this, you will be assigned to a MHP team, which consists of several providers and health care professionals who will become familiar with you and your health care needs. When you and your provider know each other, you can become partners, working together to improve your overall health and wellness.
  • Increasing access to your provider and health care team.
    We want to make sure that when you need an appointment, you can get one. MHP also offers modern communication tools that you can use to contact your provider or health care team by phone, online, or secure email to address any non-urgent questions or needs. Whether you have a health-related question, need to schedule an appointment, or request a medication refill, your health care team is within reach.

Who Are the Members of the Medical Home Port Team?

The care provided by the MHP is team-based and patient-centered. This means that, even though you have an assigned provider, you also have access to other health care providers to take care of you. MHP teams include other providers, nurses, behavioral health specialists, and support staff. Some clinics may also have pharmacists, case managers, and nutritionists on the team. They all play an important role in keeping you healthy by supporting most of your health and wellness needs in one location – your Medical Home Port.

Primary Care Manager (PCM)

Your PCM, also known as your provider, is responsible for your overall health care needs. They will address your medical issues in a compassionate manner using evidence-based clinical guidelines and engaging you as a partner in your care. They can prescribe the medications and treatments needed to keep you healthy or manage an illness, and they’ll refer you to specialists when needed.

Team Nurse

Your team nurse helps make sure that you get the care you need by working with your provider to coordinate health care services. Team nurses can also answer many of your health-related questions including those about medications, medical tests and procedures, and more. When you contact your team nurse with concerns or questions, you just might save yourself some time by avoiding an unnecessary appointment.

Internal Behavioral Health Consultant (IBHC)

When part of the MHP team, the IBHC helps improve overall health and wellness by addressing any psychological/behavioral health needs. An IBHC can help with behavior change that leads to improved health. They provide services within the MHP, so there’s no need to go to another location for additional care.

Clinical Pharmacists

When part of the MHP team, a clinical pharmacist can provide information about your medications, explain how a current medication may react with a new one, renew prescriptions, and even adjust the dose of your medications to meet your individual needs.

Nutritionist/Dietitian

Some MHP teams include a nutritionist or dietitian who can advise you on how to manage your nutrition so that what you’re eating promotes health, prevents illness, and improves quality of life.

Case Managers

When you have a case manager on your MHP team, they can connect you to the medical services and community resources that you may need to manage an illness or chronic medical condition. The more complicated the medical condition, the more comprehensive the services provided by a case manager. Their goal is to serve as a link between the MHP and other health services outside of your provider’s office to make the process of getting the care you need as easy as possible.

Health Coaches

A health coach can help you achieve levels of health that may not be possible on your own. They can guide you to better health through supporting behavioral change and lifestyle modification. They will establish an accountability partnership with you to help you identify and achieve realistic health goals by working through obstacles and providing you with educational materials, linking you with social and community resources, and promoting personal support systems.

Behavioral Health Care Facilitators (BHCFs)

BHCFs support your health care provider and you with conditions like depression, PTSD, anxiety by helping you stick with your treatment plan, reaching out to you periodically to offer support, and serve as an extension of your provider by providing continuity of care and monitoring your progress. BHCFs are not therapists, but are there to help you engage in counseling.​​

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