In remote St. Johnsbury, the local team works with Angie Moulton, 40, to keep her lupus in check, ensures she has a machine to check her blood levels weekly at home rather than traveling to Northeastern Vermont Regional Hospital, pays for a taxi to get her to healthier living workshops, and even helped the mother of two get presents for her kids during their first Christmas in Vermont. "We were able to have a Christmas because of them," says Moulton, whose family relocated from Florida last year.
"The team will make sure someone's needs are met," notes Laural Ruggles, project manager for the community health team in the St. Johnsbury region. The teams ultimately help patients self-manage their health. Anyone can seek assistance from a community health team, regardless of whether they have insurance or not. The state, Medicare and commercial insurers all contribute to support extra payments—ranging from $1.30 to $2.45 per patient per month—to PCMHs and to help fund the community health teams that dot Vermont, extending the reach of the primary care practices.
A five-year review of the program showed a slowing in growth of health care costs and hospitalizations and favorable results for preventive and effective care measures. The review noted that the program could further lower emergency department visits and boost eye exams for diabetics, but overall many PCMH patients were positive about the improved service. "I couldn't ask for a better health care team than what I have in Vermont," says Moulton.
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