Mountain Laurel Medical Center (MLMC) is driving improvements in patient health outcomes by embracing an integrated, team-based approach to care. Through its Advanced Primary Care model, the practice prioritizes collaboration, patient engagement, and comprehensive support services to address both physical and social health needs.
At the heart of this model is the Collaborative Care Team, who works together to support patients in achieving their health goals. The team includes medical providers, behavioral health providers, nurse care coordinators, medical assistants, and community health workers. Each member plays a crucial role in enhancing patient care.
Behavioral health providers assess and treat mental health concerns, while medical providers work closely with the team to develop tailored treatment plans for each patient. Nurse care coordinators work with patients after hospital visits and create care plans for those managing chronic conditions. Medical assistants facilitate day-to-day operations, performing clinical tasks such as taking vital signs and updating medical records. Community health workers focus on addressing the social determinants of health, factors like food insecurity, transportation challenges, and utility issues, that can hinder patients from managing their conditions. By helping patients access the resources they need, these workers ensure a more complete approach to care.
In addition to personalized care, MLMC is committed to increasing access to health services. The practice adjusts appointment schedules to meet patient demand and reserves daily same-day appointments for urgent or acute care needs. Extended hours at all practice locations allow patients to receive care that fits their schedules and a 24/7 on-call provider ensures patients have access to care outside of regular hours as well.
Through Chronic Care Management (CCM), Nurse Care Coordinators help patients manage conditions such as diabetes and hypertension between office visits, offering education and facilitating communication with healthcare providers. They also coordinate the transition of care from hospitalizations, emergency room visits, and nursing home stays back to the patient’s Mountain Laurel care team. Annual wellness visits coordinated with the Provider and the Nurse Care Coordinator provide an opportunity to ensure care plans are maintained, baselines are measured, and optimal communication.
Patient engagement is a cornerstone of MLMC’s approach. The patient portal offers 24/7 access to lab results, appointment scheduling, bill payments, and communication with the care team. Annual advisory meetings with the Friends of Mountain Laurel allow patients to provide feedback on the center’s operations, and MLMC’s consumer-majority Board of Directors ensures that patient needs and perspectives inform decision-making at the highest levels.
Mountain Laurel prioritizes quality improvement across all areas of care by tracking a variety of clinical measures. With a commitment to value-based care, the center continuously monitors performance and implements new strategies to enhance patient outcomes.
Technology plays a key role in improving the patient experience. MLMC utilizes an electronic health record, telehealth services, remote patient monitoring, and a patient portal to streamline care delivery and communication. These advancements ensure that patients receive timely and coordinated care.
Ultimately, the Advanced Primary Care model at Mountain Laurel Medical Center is designed to provide better support, foster clear communication between patients and providers, and improve health outcomes. Studies have shown that this model not only keeps patients healthier but also saves time and resources, making it a powerful tool in the ongoing effort to enhance healthcare delivery.