The patient-centered medical home (PCMH) is a model of care that puts the focus primarily on patient needs. It emphasizes coordination of care including attention to effective communication. Practitioners, payers, and patients alike increasingly recognize the need for the PCMH in the United States, especially as reform efforts seek to control costs and improve quality of care delivery.
Many healthcare providers see the PCMH as a way to approach population health issues in a more efficient way, but there may be several challenges and difficulties that lie ahead.
Medical home growth has been significant; In Michigan, Blue Cross and Blue Shield has 3770 physicians in 1243 primary-care practices as medical home providers, and an additional 1000 practices in the planning. An estimated 2 million residents in Michigan receive care from one of these doctors. PCMH’s usher better coordinated care by improving patient access (ie, including extended office hours), better documentating patients conditions through the use of electronic health records, and reducing readmissions by monitoring the sickest patients.
While medical home growth has been impressive, research has not necessarily shown cost savings and quality improvements. Challenges lie in shifting physicians from the single-patient focus, as well as moving away from the fee-for-service model.
Dr Xavier Sevilla, vice president of clinical quality at Catholic Health Initiatives said their hospital sees the PCMH as a positive. “We're building our system for the future to take advantage of value-based care,” he said.
Insurers seem to agree with the hospital perspective. “We want to shift away from fee-for-service office visits into care coordination, non-face-to-face services and coaching,” said Dr Eunah Fischer, chief medical officer for Blue Cross and Blue Shield of North Dakota. “The patient-centered medical home concept is critical to our overall strategy.”
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