Patient Centered Medical Home
Right for our office. Right for you. 

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​Isabella Citizens for Health, Inc. is recognized by the National Committee for Quality Assurance (NCQA) as a Patient Centered Medical Home (PCMH).  A PCMH is a trusting partnership between a doctor-led health team and an informed patient.  It includes an agreement between the doctor and the patient that acknowledges the role of each in a total health care program.  

As part of our PCMH orientation,  we will ask you to acknowledge our agreement to you.  Our goal is to provide excellent care to you. 

We appreciate the opportunity to provide you with medical services.  The information that follows is designed to answer the questions most frequently asked by our patients.  We want you to know our policies and methods of practice.  If you have any questions, please ask us. 

We will:

  • Ask what your goal is, or what you want to do to improve your health. 
  • Ask you to help us plan your care and to let us know if you think you can follow the plan. 
  • Create written copies of care plans for more complex illnesses. 
  • Have the care team members doing more and/or different parts of care. 
  • Remind you when tests are due so that you can receive the best quality of care. 
  • Ask you to have blood tests done before your visit so the doctor has the results at your visit. 
  • Explore methods to care for you better, including ways to help you care for yourself. 

We trust you, our patients, to:

  • Tell us what you know about your health and illnesses. 
  • Tell us about your needs and concerns. 
  • Take part in planning your care. 
  • Follow the care plan that is agreed upon -- or let us know why you cannot so we can try to help or change the plan. 
  • Tell us what medications you are taking and ask for a refill at your office visit when you need one. 
  • Let us know when you see others doctors and what medications they put you on or change.
  • Ask other doctors to send us a report about your care when you see them. ​
  • Seek our advice before you see other physicians.  We may be able to care for you and we know about the strengths of various specialists. 
  • Learn about wellness and how to prevent disease. 
  • Learn about your insurance so you know what it covers. 
  • Respect us as individuals and partners in your care. 
  • Keep you appointments as scheduled, or call and let us know when you cannot. 
  • Give us feedback so we can improve our services. (We may survey you in the future to understand this better.)

We will continue to:

  • Provide you with a care team who will know you and your family. 
  • Respect you as an individual -- we will not make judgements based on race, religion, sex, age, disability, etc.
  • Respect your privacy -- your medical information will not be shared with anyone unless you give us permission or it is required by law. 
  • Provide care given by a team of people led by your physician. 
  • Give the care you need when you need it. 
  • Give care that meets your needs and fits with your goals and values. 
  • Give care that is based on quality and safety. 
  • Have a doctor on call 24 hours a day and 7 days a week. 
  • Take care of short illness, long-term disease, and give advice to help you stay healthy. 
  • Tell you about your health and illnesses in a way you can understand. 
  • Improve your care by using technology -- like electronic prescribing -- and we will strive to continuously improve. 
The nine consumer principles of the Patient Centered Medical Home (PCMH) are: 
  1. The patient has ready access to care.
  2. The PCMH "knows" the patients, and provides care that is whole-person oriented, and is consistent with the patients' unique needs and  preferences. 
  3. There is an interdisciplinary team that guides care in an accessible, continuous, comprehensive, and coordinated manner. 
  4. The PCMH takes responsibility for coordinating the patient's health care across care settings and services over time, with consideration and collaboration with the patient and the patient's family. 
  5. Patients and clinicians are partners in the patient's treatment decisions. 
  6. Open communication between the patient and the patient's care team is encouraged and supported. 
  7. Patients and their caregivers are supported in managing the patient's health. 
  8. The PCMH is an environment where trust and respect are fostered. 
  9. The PCMH provides care that is safe, timely, effective, efficient, equitable, patient-centered and family-focused. 
As we build your Medical Home, you will notice some changes in the way we provide care, but many things will stay the same.