CLOSING THE DIVIDE:HOW MEDICAL HOMES PROMOTE

EQUITY IN HEALTH CARE

Results from theCommonwealth Fund 2006 Health Care Quality Survey

THECOMMONWEALTH

FUND

Anne C. Beal, Michelle M. Doty, Susan E. Hernandez,Katherine Shea, and Karen Davis

June 2007

THECOMMONWEALT

HFUND

EXECUTIVE SUMMARY

THECOMMONWEALT

HFUND

17 13 1710

811

835

14

9

0

25

50

75

Total White African

American

Hispanic Asian

American

Uninsured now Insured now, time uninsured in past year

Percent of adults 18–64

2621

28

18

49*

Figure ES-1. Nearly Half of Hispanics and One of FourAfrican Americans Were Uninsured for All or Part of 2006

* Compared with whites, differences remain statistically significant after adjusting for income.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

Figure ES-2. Indicators of a Medical Home(adults 18–64)

Total Percent by Race

IndicatorEstimated millions Percent White

African American Hispanic

Asian American

Regular doctoror source of care 142 80 85 79 57 84

Among those with a regular doctor or source of care . . .

Not difficult to contact provider over telephone

121 85 88 82 76 84

Not difficult to get care or medical advice after hours

92 65 65 69 60 66

Doctors’ office visits are always or often well organized and running on time

93 66 68 65 60 62

All four indicatorsof medical home 47 27 28 34 15 26

Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

20 9

5461 54

39

27 30 34

4512

16*

0

25

50

75

100

Total Insured all year,

income at or above

200% FPL

Insured all year,

income below

200% FPL

Any time

uninsured

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Percent of adults 18–64

Figure ES-3. Uninsured Are Least Likely to Have aMedical Home and Many Do Not Have a Regular Source of Care

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with insured with income at or above 200% FPL, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

74767474

50525352

343138

44

0

25

50

75

100

Total White African American Hispanic

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Figure ES-4. Racial and Ethnic Differences in Getting Needed Medical Care Are Eliminated When Adults Have Medical Homes

Percent of adults 18–64 reporting alwaysgetting care they need when they need it

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

64646665

49485452

22 23 2521

0

25

50

75

100

Total White African American Hispanic

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Figure ES-5. When African Americans and HispanicsHave Medical Homes They Are Just as Likely as Whites

to Receive Reminders for Preventive Care Visits

Percent of adults 18–64 receiving a reminderto schedule a preventive visit by doctors’ office

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

65 67

5347

30*17*

0

25

50

75

100

Insured all year Any time uninsured

Medical home

Regular source of care, not a medical homeNo regular source of care/ER

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure ES-6. Patients with Medical Homes—Whether Insured or Uninsured—Are Most Likely

to Receive Preventive Care Reminders

Percent of adults 18–64 receiving a reminderto schedule a preventive visit by doctor’s office

THECOMMONWEALT

HFUND

Figure ES-7. Adults with a Medical Home Are More Likelyto Report Checking Their Blood Pressure Regularly

and Keeping It in Control

2942

25

1510

17

56 48 58

0

25

50

75

100

Total Medical home Regular source of care,

not a medical home

Does not check BP

Checks BP, not controlled

Checks BP, controlled

Percent of adults 18–64with high blood pressure

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

Figure ES-8. Indicators of a Medical Homeby Usual Health Care Setting

(adults 18–64)

Usual Health Care Setting

Indicator TotalDoctors’

office

Community health center

or public clinic

Other settings*

Regular doctor or source of care 80% 95% 78% 63%

Among those with a regular doctoror source of care . . .

Not difficult to contact provider over telephone 85 87 77 77

Not difficult to get care ormedical advice after hours 65 67 54 69

Always or often find visits to doctors’ office well organizedand running on time

66 68 56 60

All four indicators of a medical home 27 32 21 22

* Includes hospital outpatient departments and other settings.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

HEALTH CARE COVERAGEAND A MEDICAL HOME

FOR MINORITIES

THECOMMONWEALT

HFUND

17 13 1710

811

835

14

9

0

25

50

75

Total White African

American

Hispanic Asian

American

Uninsured now Insured now, time uninsured in past year

Percent of adults 18–64

2621

28

18

49*

Figure 1. Nearly Half of Hispanics and One of FourAfrican Americans Were Uninsured for All or Part of 2006

* Compared with whites, differences remain statistically significant after adjusting for income.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

78 8275

84

53*

0

25

50

75

100

Total White African

American

Hispanic Asian

American

* Compared with whites, differences remain statistically significant after adjusting for income.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Percent of adults 18–64 insured all year withat least one full-time worker in their family

Figure 2. Hispanics Are Least Likely to HaveContinuous Insurance Coverage Even Whena Family Member Has Full-Time Employment

THECOMMONWEALT

HFUND

Percent of adults 18–64 with following insurance sources at time of survey

^ Includes Medicare and Medicaid.* Compared with whites, results are statistically significant even after controlling for income.Source: Commonwealth Fund 2006 Health Care Quality Survey.

63

68

71

12

9

7

8

10

6

6

17

13

10

3543

54

16

23*

12

17

Total

White

Asian American

African American

Hispanic

Employer Public^ Individual/Military/Other Uninsured

Figure 3. Hispanics and African Americans Are Least Likelyto Have Health Insurance Through an Employer

THECOMMONWEALT

HFUND

* Compared with insured with income at/above 200% poverty, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.

5561 61

36*

0

25

50

75

Total Insured all year,

income at or above

200% FPL

Insured all year,

income below

200% FPL

Any time

uninsured

Figure 4. Uninsured Are Less Likely to Report Always Getting the Care They Need When They Need It; Low-Income Adults, When Insured,

Are as Satisfied as Higher-Income Adults

Percent of adults 18–64 reporting alwaysgetting care they need when they need it

THECOMMONWEALT

HFUND

54 55

3644

28*30

5056

0

25

50

75

100

Total White African

American

Hispanic Total White African

American

Hispanic

Percent of adults 18–64 receiving a reminderto schedule a preventive visit by doctor’s office

Figure 5. When Insured, Minorities Are Just as Likelyas Whites to Receive Reminders for Preventive Care Visits; Rates Are

Low for All Uninsured Adults, Especially Hispanics

Insured all year Any time uninsured

* Compared with whites, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

2015 16

21*

43*

0

25

50

75

Total White African

American

Hispanic Asian

American

Percent of adults 18–64 with no regular doctor or source of care

Figure 6. Hispanics Are Most Likely to Be Withouta Regular Doctor or Source of Care

* Compared with whites, differences remain statistically significant after adjusting for age, income, and insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

Figure 7. Indicators of a Medical Home(adults 18–64)

Total Percent by Race

IndicatorEstimated millions Percent White

African American Hispanic

Asian American

Regular doctoror source of care 142 80 85 79 57 84

Among those with a regular doctor or source of care . . .

Not difficult to contact provider over telephone

121 85 88 82 76 84

Not difficult to get care or medical advice after hours

92 65 65 69 60 66

Doctors’ office visits are always or often well organized and running on time

93 66 68 65 60 62

All four indicatorsof medical home 47 27 28 34 15 26

Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

15 16

54 58 45

42

59

27 28 26

20 2143

15*34*

0

25

50

75

100

Total White African

American

Hispanic Asian

American

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Percent of adults 18–64

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with whites, differences remain statistically significant after adjusting for income and insurance. Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 8. African Americans and Hispanics Are More Likelyto Lack a Regular Provider or Source of Care;

Hispanics Are Least Likely to Have a Medical Home

THECOMMONWEALT

HFUND

THE IMPORTANCE OFA MEDICAL HOME:

ACCESS

THECOMMONWEALT

HFUND

20 9

5461 54

39

27 30 34

4512

16*

0

25

50

75

100

Total Insured all year,

income at or above

200% FPL

Insured all year,

income below

200% FPL

Any time

uninsured

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Percent of adults 18–64

Figure 9. Uninsured Are Least Likely to Have a Medical Home and Many Do Not Have a Regular Source of Care

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with insured with income at or above 200% FPL, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

55

74

52*

38*

0

25

50

75

100

Total Medical home Regular source of

care, not a medical

home

No regular source

of care/ER

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 10. The Majority of Adults with a Medical HomeAlways Get the Care They Need

Percent of adults 18–64 reporting always getting care they need when they need it

THECOMMONWEALT

HFUND

55 57 56

46* 48*

0

25

50

75

100

Total White African

American

Hispanic Asian

American

* Compared with whites, differences remain statistically significant after adjusting for income.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 11. Hispanics and Asian Americans Are Less Likelyto Report Always Getting Medical Care When Needed

Percent of adults 18–64 reporting always getting care they need when they need it

THECOMMONWEALT

HFUND

74767474

50525352

343138

44

0

25

50

75

100

Total White African American Hispanic

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Figure 12. Racial and Ethnic Differences in Getting Needed Medical Care Are Eliminated When Adults Have Medical Homes

Percent of adults 18–64 reporting always getting care they need when they need it

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

77747776

586462

55*43444643

0

25

50

75

100

Total White African American Hispanic

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Figure 13. African American and Hispanic Adults Who Have Medical Homes Have Rapid Access to Medical Appointments

Percent of adults 18–64 able to getan appointment same or next day

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with whites, differences are significant within category of medical home.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

THE IMPORTANCE OFA MEDICAL HOME:

PREVENTION

THECOMMONWEALT

HFUND

Figure 14. Adults Who Are Sent Reminders Are More Likelyto Receive Preventive Screening

Women ages 40–64who received

a mammogramin past two years

* Compared with reminders, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

82 7970

37*

62*

50*

0

25

50

75

100

Reminder No reminder

Adults ages 18–64who had their

cholesterol checkedin past five years

Men ages 40–64who received a screen

for prostate cancerin past two years

Percent

THECOMMONWEALT

HFUND

49

6552*

22*

0

25

50

75

100

Total Medical home Regular source

of care, not a

medical home

No regular

source of

care/ER

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 15. Nearly Two-Thirds of Adults with Medical Homes Receive Reminders for Preventive Care

Percent of adults 18–64 receiving a reminderto schedule a preventive visit by doctors’ office

THECOMMONWEALT

HFUND

49 53 4939* 37*

0

25

50

75

100

Total White African

American

Hispanic Asian

American

* Compared with whites, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 16. Hispanics and Asian Americans Are Less Likelyto Receive a Reminder for Preventive Care Visits

Percent of adults 18–64 receiving a reminderto schedule a preventive visit by doctors’ office

THECOMMONWEALT

HFUND

64646665

49485452

22 23 2521

0

25

50

75

100

Total White African American Hispanic

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Figure 17. When African Americans and HispanicsHave Medical Homes They Are Just as Likely as Whites

to Receive Reminders for Preventive Care Visits

Percent of adults 18–64 receiving a reminderto schedule a preventive visit by doctors’ office

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

6676 72

34*

0

25

50

75

100

Total Medical home Regular source

of care, not a

medical home

No regular

source of

care/ER

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 18. Missed Opportunities for Preventive Carefor Adults Who Lack a Regular Source of Care:Just One-Third Had Their Cholesterol Screened

Percent of adults 18–64 who had theircholesterol checked in past five years

THECOMMONWEALT

HFUND

66 67 6356*

62*

0

25

50

75

100

Total White African

American

Hispanic Asian

American

* Compared with whites, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 19. Hispanics and Asian Americans Are Less Likelyto Have Their Cholesterol Checked

Percent of adults 18–64 who had theircholesterol checked in past five years

THECOMMONWEALT

HFUND

69737576 73697172

34 36 36 36

0

25

50

75

100

Total White African American Hispanic

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Figure 20. African Americans and Hispanics with Medical Homes Are Equally as Likely as Whites to Receive Cholesterol Checks

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Percent of adults 18–64 who had theircholesterol checked in past five years

THECOMMONWEALT

HFUND

THE IMPORTANCE OFA MEDICAL HOME:

CHRONIC CARE

THECOMMONWEALT

HFUND

12 8

57 60 49 57

32 32

102617

55

34*20*

31

0

25

50

75

100

Total White African

American

Hispanic Asian

American

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with whites, differences remain statistically significant after adjusting for income and insurance. Source: Commonwealth Fund 2006 Health Care Quality Survey.

Percent of adults 18–64with a chronic disease

Figure 21. Only One-Third of Patients withChronic Conditions Have Medical Homes;

Hispanics Are Least Likely to Have a Medical Home

THECOMMONWEALT

HFUND

3531

36

48*54*

0

25

50

75

Total White African

American

Hispanic Asian

American

Figure 22. About Half or More of Hispanics and Asian Americans with Chronic Conditions Were Not Given Plans

to Manage Their Condition at Home

Percent of adults ages 18–64 with any chronic condition who were not given a plan from a doctor or nurse to manage condition at home

* Compared with whites, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

3523

35

65*

0

25

50

75

100

Total Medical home Regular source

of care, not a

medical home

No regular

source of

care/ER

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences remain statistically significant after adjusting for income or insurance.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 23. Less than One-Quarter of Adults with Medical Homes Did Not Receive Plans to Manage Their Conditions at Home

Percent of adults ages 18–64 with any chronic condition who were not given a plan from a doctor or nurse to manage condition at home

THECOMMONWEALT

HFUND

80

6573 69

39* 34*

0

25

50

75

100

Insured all year Any time uninsured

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Percent of obese or overweight adults 18–64 whowere counseled on diet and exercise by doctor

Figure 24. Adults with a Medical Home Have Higher Ratesof Counseling on Diet and Exercise Even When Uninsured

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

Figure 25. Missed Opportunities for Blood PressureManagement Exist Across All Groups, Especially Hispanics

29 31

15 10 23 39

56 59 50

2327

37*

0

25

50

75

100

Total White African American Hispanic

Does not check BP

Checks BP, not controlled

Checks BP, controlled

* Compared with whites, differences remain statistically significant after adjusting for income and insurance. Source: Commonwealth Fund 2006 Health Care Quality Survey.

Percent of adults 18–64with high blood pressure

THECOMMONWEALT

HFUND

Figure 26. Adults with a Medical Home Are More Likelyto Report Checking Their Blood Pressure Regularly

and Keeping It in Control

2942

25

1510

17

56 48 58

0

25

50

75

100

Total Medical home Regular source of care,

not a medical home

Does not check BP

Checks BP, not controlled

Checks BP, controlled

Percent of adults 18–64with high blood pressure

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

73807773

51

655858

0

25

50

75

100Medical home Regular source of care, not a medical home

Percent of adults ages 18–64 who haveseen a specialist in past two years

Figure 27. Patients with a Medical Home Report Better Coordination Between Their Regular Provider and Specialist

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time. Source: Commonwealth Fund 2006 Health Care Quality Survey.

Regular provider helped decide who

to see

Regular provider communicated with

specialist about medical history

After seeing specialist, regular

provider seemed up to date

Regular provider helped you understand

information from specialist care

THECOMMONWEALT

HFUND

THE IMPORTANCE OFSAFETY NET PROVIDERS

THECOMMONWEALT

HFUND

Uninsured any time46.8 million

Insured, income below 200% poverty22.2 million

Community health center

20%

Note: Percentages may not sum to 100% because of rounding.Source: Commonwealth Fund 2006 Health Care Quality Survey.

ER12%

Doctor’s office65%

Doctor’s office41%

Community health center

20%

ER4%

Hospital outpatient

5%

Hospital outpatient

4%

No regular place of care15%

No regular place of care

2%Other6%

Other6%

Figure 28. Community Health Centers Serve Large Numbersof Uninsured Adults and Insured Adults with Low Incomes

THECOMMONWEALT

HFUND

Percent of adults 18–64

69

77

75

11

9

13

9

6

10

12

5

3

4

6

5

4

62*

44* 21*

7

12

8

12*

1

15

Total

White

Asian American

African American

Hispanic

Doctor's office Community health center Hospital outpatient/Other

ER No regular place of care

Figure 29. Hispanics and African Americans AreMore Likely to Rely on Community Health Centers

as Their Regular Place of Care

* Compared with whites, differences remain statistically significant after adjusting for insurance or income.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

Figure 30. Indicators of a Medical Homeby Usual Health Care Setting

(adults 18–64)

Usual Health Care Setting

Indicator TotalDoctors’

office

Community health center

or public clinic

Other settings*

Regular doctor or source of care 80% 95% 78% 63%

Among those with a regular doctoror source of care . . .

Not difficult to contact provider over telephone 85 87 77 77

Not difficult to get care ormedical advice after hours 65 67 54 69

Always or often find visits to doctors’ office well organizedand running on time

66 68 56 60

All four indicators of a medical home 27 32 21 22

* Includes hospital outpatient departments and other settings.Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

56

74

4555

32

49

2535

0

25

50

75

100

Preventive reminders Cholesterol checked

Doctor's officeCommunity health centerOther regular source of careNo regular source of care/ER

Figure 31. Preventive Care Reminders and Cholesterol Screening Are More Common in Doctors’ Offices,

But Community Health Centers Are Not Far Behind

Percent of adults 18–64

Source: Commonwealth Fund 2006 Health Care Quality Survey.

THECOMMONWEALT

HFUND

65 67

5347

30*17*

0

25

50

75

100

Insured all year Any time uninsured

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.

Figure 32. Patients with Medical Homes—Whether Insured or Uninsured—Are Most Likely

to Receive Preventive Care Reminders

Percent of adults 18–64 receiving a reminderto schedule a preventive visit by doctor’s office

THECOMMONWEALT

HFUND

78

6475

59

31*38*

0

25

50

75

100

Insured all year Any time uninsured

Medical home

Regular source of care, not a medical home

No regular source of care/ER

Figure 33. Even When Uninsured, Adults with a Medical Home Have Higher Rates of Cholesterol Screening

Percent of adults 18–64 who had their cholesterol checked in past five years

Note: Medical home includes having a regular provider or place of care, reporting nodifficulty contacting provider by phone or getting advice and medical care on weekendsor evenings, and always or often finding office visits well organized and running on time.* Compared with medical home, differences are statistically significant.Source: Commonwealth Fund 2006 Health Care Quality Survey.