#pcmh

[looketha]

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[arrowheadhealth]

Patient Centered Medical Home - Arrowhead Health Centers

According to the NCQA, patient centered medical home is a model of care that strengthens the clinician-patient relationship

Patient Centered Medical Home (PCMH) Recognition is the model for transforming primary care practices into coordinated care.

Arrowhead Health Centers is achieve this through high level of accessibility, excellent communication among patients & staff, teamwork, and technology.

Learn more about PCMH here - https://bit.ly/2U14AE4

[wayfaringmd]

My doctor was celebrating that her practice just finished up something called medical home at my last visit. I was in a rush to get to work and didn't ask what it was. Do you know what that is?

The Patient Centered Medical Home (PCMH) is a model of healthcare delivery that encompasses quality primary care that focuses on the whole person. To get PCMH certification an office must meet a big list of “quality measures” and show that it has ongoing quality improvement projects. It takes a lot of work to meet all the requirements. My residency office was PCMH certified. Read more about what it is and how to get it here. 

[davidrussellschilling]

How to Measure the Success of Patient Centered Medicine

How to Measure the Success of Patient Centered Medicine

C O N T E N T S:

KEY TOPICS

Thomas Jefferson University, Department of Family and Community Medicine had a slightly different approach to the PCMH. They utilized “super” MAs to monitor data, coordinate care, identify diabetes patients, make follow up phone calls, and streamline referrals to various specialists (“Patient- Centered,” 2011).(More…)

POSSIBLY USEFUL

Patient-Centered Medical Home…

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[slowdownsimplybemd]

Patient-Centered Care Failure

I recently got blood work and a thyroid u/s done after having some strange/new symptoms I’ve never had before. So my PCP's office calls to tell me I may have a thyroiditis syndrome and I need to see an endocrinologist. OK, what does this mean? I am a little shocked and asked the MA who called to repeat why and what this means. Didn’t really get an answer, she just re-read the u/s findings of “lobulated thyroid with increased vascularity” and to follow up with the  endocrinologist.

So I called to make an appointment and this endocrinologists office is 40 minutes away and cannot get me in until the end of April! I am so anxious and if something is wrong I want to find out NOW rather than a month or two before I start medical school! 

So I called my PCP back to see if there was anyone else and they said this is the only endocrinologist they work with. I then decided to call my insurance and they said there are about 10 endocrinologists that are WAYYY closer to me and in-network (maybe could get me in sooner too?). I explained this to my PCP and her office and they refused to give me a referral (required with my insurance) to anyone other than this one doctor. So I called my insurance AGAIN and asked them about this to see if I really could only go to this one doctor. They actually called my PCP’s office to confirm that I was in-network and could go to any of said doctors and the PCP’s office will not budge! So my insurance said the only way to go to a different endocrinologist is to find a different PCP that is willing to refer me. UGHHH. Why are they doing this! All the PCP’s in my area take MONTHS to get into as a new patient, I DO NOT have time for that!

What really gets me the most about this is that my current PCP’s office calls itself a Patient-Centered Medical Home, where the physicians and office strive to maintain a partnership with patients and provide personalized care, that meets individuals needs.

Well they are doing a shitty ass job of this. They know I will be out of the state for school in 4 months and they know I have mental health problems I am working on. If I have a thyroid problem that could be worsening my mental health symptoms (which the PCP suspected) I don’t understand why they won’t get on board with helping me go to a specialist that would work better for me and help me sooner. SO NOT PATIENT-CENTERED, at least in my eyes.

If ya’ll didn’t notice I'm stressing a bit here/ANGRY. Deep breaths UGHH. 

[hprc-info]

Patient Centered Medical Homes

The basic idea behind a patient centered medical home (PCMH) is that the patient would have a provider-managed, team-based, data-driven ‘home’ where they would typically go for their care. This home would be a physical location such as a clinic, or any location that enables regular interaction with the health care system.

The PCMH would manage and coordinate all aspects of their primary care (public health, clinical, and social services), from check-ups and screenings to prescriptions and office visits, and then manage and coordinate specialist care whenever necessary. 

The data from all these interactions would be the dashboard that helps providers determine whether the patient is improving. In addition - when patients with similar characteristics are taken as a group the data could assist providers and policymakers in planning for and responding to the health needs and outcomes of entire populations. For policymakers and payers there’s also the ultimate score-keeper - improving health and health care while saving the system money.

The question of the day is whether or not the model works. Recent evidence based on a review of claims data from 2006 to 2013 at one PCMH has yielded encouraging results. As reported in a recent issue of Health Affairs, researchers found that Geisinger Health System’s PCMH in Pennsylvania actually improved care while saving their system money, largely due to reduced acute inpatient care. Earlier interventions in the disease progression, and more effective team-based care along the way, reduced the need for more complex (and more costly) care downstream, thus reducing overall costs.  

Researchers estimated that PCMH exposure led to a 7.9% decrease in total costs, of which acute inpatient care represented 64% (about $34 per member per month) of the savings. It helps that Geisinger is a fully integrated system that uses a ‘Navigator’ model. This navigator is a case manager that is “embedded” (or located) at the clinics to help coordinate each patient’s care. 

Many have surmised that the PCMH model can help reduce health disparities and place the nation’s most vulnerable on the path toward health equity (simply put - the scenario within which everyone has a fair shot at being healthy, no matter their station in life). This discussion paper from the Institute of Medicine (IOM) is a case in point.  

While it may be premature to declare victory on the health equity question, the Patient-Centered Primary Care Collaborative recently reported the impact of PCMH on cost and quality. Again, the numbers are encouraging. In Maryland, CareFirst BlueCross BlueShield’s PCMH reported $98 million in cost savings between 2010-2012, and a 9.3% increase in quality scores for PCMH panels from 2011-2012.

The challenge for the health equity community is to be able to measure the impact of PCMH across populations. The Affordable Care Act (ACA) intends to enable such measurement. Under the ACA, Accountable Care Organizations (ACOs) - which operate as PCMH ‘neighborhoods’ for Medicare patients - will attempt to improve care among their populations while reducing costs. Savings are shared between the federal government and providers, and increases in cost are borne by the providers. The results thus far - both from a quality of care and financial performance standpoint - have been mixed. 

We will continue to watch this space.

[ac1dhologr4m]

Some pictures i took at the BTBAM show last night in Portland, Maine

[teamcaremedicine]

What is Needed for the Medical Home to Reach its Full Potential?

When the Pickup Truck Meets the 18 Wheeler

Let’s take a quick look at what we know or at least what we may have read or heard.  A Rand Corporation study, presented in JAMA in 2014, compared a group of practices that had achieved patient-centered medical home (PCMH) recognition from the National Committee for Quality Assurance (NCQA) with a similar number of control practices that did not receive…

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