Measuring the success of a patient-centered medical home

Measuring the success of a patient-centered medical home

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A patient-centered medical home, or PCMH, is a collaborative, team-based model of care led by a personal physician who provides continuous and coordinated care — including preventive services, treatment of acute and chronic illnesses, and end-of-life care — throughout a patient’s lifetime to maximize health outcomes in a culturally and linguistically appropriate manner. The PCMH has recently gained national attention as a way to reengineer the care-delivery process to improve quality and reduce the cost of care. Although preliminary studies suggest the PCMH can result in improved population health, enhanced patient experience, and reduced/controlled per capita cost of care, the lack of standardized measurements across PCMHs impedes the ability to compare them to each other, as well as to other payment and care delivery models, such as accountable care organizations and Medicare Advantage plans.

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Special comment: Can more primary care bend the cost curve?

The recent Commonwealth Fund report “Paying More for Primary Care: Can it Help Bend the Medicare Cost Curve?” studies a provision of the Patient Protection and Affordable Care Act intended to readjust health care delivery toward primary care to reduce Medicare costs. The report examines the five-year 10 percent increase in Medicare payments for primary care services, specifically evaluation and management (E&M) services, and uses a simulation model to predict how a permanent payment increase would better grow the use of primary care E&M services, thus reducing total Medicare spending. Continue reading “Special comment: Can more primary care bend the cost curve?” »

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Read of the week: Evolution of the primary care physician

The uncertain future of health care in the United States creates numerous questions about the role of the primary care physician in emerging and as-yet undiscovered care delivery models. The New England Journal of Medicine explores these changes in this week’s 200th anniversary article “The Evolving Primary Care Physician.” It presents a multitude of issues impacting primary care doctors, including advances in medical knowledge and technology, job satisfaction, workflow changes, and the narrowing scope of practice. The author offers two solutions to ensuring the relevance of the primary care physician: training on team-based care, and regular collaborative work experience with other health care professionals during medical school and residency programs. As the U.S. health care system moves toward team-based care in delivery models such as patient-centered medical homes, accountable care organizations, and bundled payment models, this type of collaborative training is essential for the future viability of the profession. Visit the site