How one practice transformed into a patient-centered medical home

It wasn’t an easy transition, say the doctors at a Virginia pediatric practice that achieved certification as a patient-centered medical home.

“First, you have to get a buy-in, not just from the providers but from the whole staff. Because this isn’t just change, it’s transformation,” Scott Keel, M.D., complex care coordinator at Pediatric & Adolescent Health Partners based in Midlothian, Virginia told the Richmond Times-Dispatch.

More than 11,000 certified practices are recognized as medical homes in the country. The upfront costs for practices to transition to a medical home are hefty, estimated at about $31,000 by one study.

Insurance giant Anthem, which encourages practices to switch to a model of care that allows for value-based payments, worked with the practice to help it achieve its certification from the National Committee for Quality Assurance (NCQA). Anthem assigned navigators to the practice, who would visit every few weeks to help it reach its certification.

The certification took more than a year. But the end result was worth it, according to Keel and Ted Abernathy, M.D., who founded the practice. It has 29 staff members and nine providers in three locations that serve about 20,000 patients. Patients know the nurses and receptionists as well as their physicians.

Day-to-day tasks are distributed among the staff to streamline operations and allow providers to send more time with patients, according to the newspaper. “The nurses, the doctors, the front office staff--satisfaction has gone up across the board, even though it’s more work,” said Keel. 

The change to a patient-centered medical home requires an efficient method of tracking data and keeping records. But probably the most challenging implementation for the staff, Abernathy said, is paying attention to patients' social determinants of health.