business
Patient-centered medical homes gaining ground
■ A survey finds widespread adoption and interest in the model, but establishing one poses risks.
By Emily Berry — Posted Aug. 10, 2011
- WITH THIS STORY:
- »
- » Related content
Among 341 practices that responded to a survey by the Medical Group Management Assn. in March and April, 67.8% were either on their way to becoming a patient-centered medical home or interested in becoming one.
An additional 21.4% already were accredited or recognized by an insurer or national body as meeting the definition of a medical home.
The patient-centered medical home practice model has been successful because it is both independent and compatible with the Patient Protection and Affordable Care Act, including the accountable care organization model, said Dave Gans, MGMA's vice president of innovation and research.
"Whether part of an ACO or part of a standard fee-for-service arrangement, a patient-centered medical home still functions well," he said.
Gans said patient-centered medical homes also have the advantage of being around long enough for research to back claims that they can improve care and save money.
For example, a recent study from the University of California, Davis found cost savings from lower specialty care utilization and hospitalizations associated with the patient-centered medical home model.
Of the 26.7% practices that are becoming a patient-centered medical home, 39% were multispecialty with both primary and specialty care and 32.5% were family medicine.
Of the 21.4% that have established medical homes, the most common processes they were engaged in as part of the model were assigning patients to a primary care clinician, addressing mental health issues and referring those patients to appropriate agencies, exchanging clinical information electronically with pharmacies, and involving patients and family members in decision-making with doctors.
Establishing and maintaining a medical home isn't without challenges, Gans said. Funding for patient monitoring and follow-up care isn't guaranteed. Many insurers have sponsored pilot or demonstration programs, but those programs and incentive payments aren't locked in forever, which makes it riskier for a physician to hire a nutritionist or another nurse to help coordinate care, he said.
