Patient-Centered Medical Homes Solve Some Big Problems in Healthcare: White Paper
Patient-Centered Medical Homes (PCMH) are growing in number across the U.S. The medical home is no longer just a concept, thanks to provisions in the Affordable Care Act (ACA), which call for the government to begin supporting efforts to establish and test medical homes.
Patient Centered Medical Homes are being Developed Country-Wide
Currently, more than 40 states are developing patient-centered medical home programs through the Medicaid and Children’s Health Insurance Program (CHIP). Additionally, the Centers for Medicare & Medicaid (CMS) Innovation Center, formed through the ACA, supports the advancement of primary care services through its Comprehensive Primary Care Initiative, a public/private collaboration that provides funding for primary care activities that take place outside of the physician-patient visit. As well, the Federally Qualified Health Center Advanced Primary Care Practice Demonstration includes 500 community health centers in 44 states that are receiving funding to reorganize as patient-centered medical homes.
PCMHs are NOT Just Government Solutions—Employers and Insurers are Involved!
But it’s not just government that is promoting the rapid growth of PCMHs. A multitude of healthcare stakeholders are either starting or supporting PCMH initiatives, including medical groups, medical societies, insurers, quality organizations, and large employers. As of June 2012, the National Committee for Quality Assurance (NCQA) recognized 4,220 PCMHs, a big leap from 3,300 practices at the end of 2011. Large insurers, such as Aetna and WellPoint Inc., as well as integrated delivery networks, including Group Health in Seattle, have launched PCMH networks.
An Emphasis on Patient-Centered Care
The patient-centered medical home is gaining ground because it provides a solution to a big industry problem: lack of patient-centered care. By coordinating all care through the primary care medical practice, the PCMH is poised to address the healthcare needs of growing numbers of patients with chronic, complex conditions and the Baby Boomers who are entering their senior years.
The PCMH model offers financial incentives for primary care physicians (PCP) to form and direct caregiver teams comprised of specialists, nurses, pharmacists, social workers, chiropractors, and other healthcare resources to provide specific services for the patient, saving time and costs, and ideally improving quality and patient outcomes.
Better in Terms of Patient and Financial Outcomes
In addition to the PCMH taking a significant step toward providing “whole” patient care, the opportunity for financial rewards is great. Already, some large pilots are demonstrating millions in savings. These favorable outcomes mean 2013 is likely to be an even bigger growth year as primary care physicians and others decide the time is now to enter the medical home business.
This white paper examines:
- The PCMH Model and its value for optimizing patient care
- How medical homes can be agents of change
- Why an emphasis on primary care can deliver positive results
- How NCQA recognition is critical to PCMH success
- How HealthStream supports practices seeking NCQA recognition and distinction
Download the White paper.