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Patient Centered Medical Home model – Rewards of a successful transformation

By Joshua Bennett, MD, MBA  /  26 Aug 2015

joshua bennettWith healthcare facing pressures to transform the way care is organized and delivered, providers must find new ways to deliver high-quality, accessible, efficient patient care. One model that is growing in popularity since its inception in the late 1960s, and promises a way for better healthcare, is the Patient Centered Medical Home (PCMH). According to the National Committee for Quality Assurance (NCQA), more than 10 percent of the U. S. primary care practices are recognized as a PCMH, and in a recent MGMA survey of 30,000 practices, 44 percent of practices wanted to become a PCMH.

The PCMH holds promise as a way to improve healthcare by transforming how primary care is organized and delivered. Structured as a care delivery team, a PCMH is a primary care office where the provider is the “captain” of the team and the office staff provides care at the top level of their clinical licenses. In the PCMH context, a provider could be a physician, nurse practitioner or physician assistant.

So what’s convinced so many practices to want to change?

  • Comprehensive care for increased engagement – One of the leading principles of the PCMH is to treat the patient as a whole person, covering comprehensive care from prevention and wellness to acute or chronic care. Care is coordinated across the health system – hospitals, home care, skilled nursing homes, and specialists – to improve patient outcomes and provide an opportunity to open the door for easier patient engagement and prevent duplication of services and clinical errors. Technology is another access point for patient engagement, in providing information such as a website, patient portal, scheduling, clinical information, health records and 24/7 electronic access, so that patients can access services even quicker and easier than with the technology available in a traditional model.
  • Strong patient-physician relationship – Within a PCMH, the ongoing relationship between patients, providers, and their clinical team, is a priority. Patients work with a consistent team of providers, who learn about a patient’s health, as well as preferences, communication styles and values, so that care decisions can be made together. This strong relationship between patients and their providers also helps ensure patients and their families make informed decisions. With the PCMH model, providers collect patient experiences and gauge patient satisfaction, and by combining those insights with performance measurement and improvement, providers are able to provide more personalized care to their patients.
  • Lower costs and higher quality – Cost is a concern to everyone who plays a role in healthcare, and due to the increased accessibility and proactive mindset among physicians in PCMH, the value is seen by more than just the patient and doctor. For patients, the PCMH helps to reduce medical costs. A Patient Centered Primary Care Collaborative report analyzing 20 peer-reviewed studies on medical homes, found that about 60% showed a decrease in the cost of patient care. From the provider’s perspective, the model improves clinical outcomes through coordinated care and demonstrates to both local and government health plans, the need for increased reimbursement for this additional care management and coordination.

Not all practices may be a right fit to be a formal accredited PCMH. However, when boiled down to the basics, many of the characteristics of the model can be instilled in most practices due to one common goal – bringing care coordination to the forefront of care delivery.

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