Attachment A
PRIMARY CARE SERVICES

Primary Medical Care:
Diagnostic Labs to include at minimum: Comprehensive Metabolic Profile ( electrolytes, BUN, creatinine, ast. alt, billirubin, albumin, glucose, calcium, co2, chloride),
Lipid Panel to include HDL and LDL as well as Total Cholesterol and Triglycerides,
CBC, Urinalysis and Culture, Urine for creatinine and albumin, TSH, Hemoglobin A1C, PSA, Pap, Hemoccult
Diagnostic X-ray and testing to minimally include: Chest X-ray and studies of the extremities, spirometry
Diagnostic Testing/Screening to include at minimum: Pelvic/Pap, Breast Exam, Rectal Exam, Prostate Exam
After Hours Availability
Urgent Care/Drop-In Availability
24 Hour On-Call Clinician
Family Planning
Immunizations: Childhood Immunizations and Adult immunizations (Influenza and Pneumovax and tetanus at minimum) either provided on site or through a relationship with another entity
Physical Examinations
Sick Care for Acute Illnesses
Chronic Disease Management
Patient Education

Gynecologic Care:
Routine Gynecologic Care
Pap Smears
Postmenopausal Women’s Care
Basic Prenatal Counseling and Referral to Obstetric Care (or onsite care)

Dental Care:
Routine Assessment by inspection and patient education

Mental Health Services:
Depression Screening and Treatment and Counseling
Anxiety Screening and Treatment and Counseling
Patient Education

Preventive Services Related to Target Areas:
Pap smear
Digital Rectal Exam
Fecal Occult Blood Test
Smoking Cessation Classes and/or Counseling
Skin Cancer Surveillance
Influenza Vaccination
Pneumonia Vaccination
Clinical Brest Exam (Mammogram/only if offered at the clinic)

Diabetes:
Hemoglobin A1C Screening and Treatment
Urine Microalbumin Screening and Treatment
Diabetic Foot Exam
Retinal Exam – Non-dilated Cursory Eye Exam
Blood Pressure Monitoring and Treatment
Cholesterol Monitoring and Treatment
Patient Education

Cardiovascular Disease:
EKG
Blood Pressure Monitoring and Treatment
Weight Reduction Program
Blood Cholesterol Screening and Treatment
Patient Education

Pharmacy Services:
For medical homes with a 340b pharmacy, patients may be eligible for reduced drug prices offered through that program.
Many pharmaceutical companies offer patient assistance programs, and eligible patients are encouraged to apply
Patients need to have access to the following medications at minimum: simvastatin, metformin, enalapril or captopril, regular and long acting insulin and supplies, b-blockers, hydrochlorothiazide and lasix.

Excluded Services (Please note that these services are simply not required. A medical home very well may offer these services, but they are not required to do so.):
Colonoscopy
Mammography
Chemotherapy/Radiation
Surgery
Cardiac Stress Testing
Obstetric Care
ER Visits in a Hospital Setting
Radiology Procedures (Echocardiography, Ultrasound, MRI, CT Scans)
Complete Drug Formulary
Respite/Hospice Care
Inpatient Hospital Services
Catastrophic Care
Complicated Orthopedic Care