4 ways PCMH practices differ from traditional medical offices

Team of doctors talking
More practices could transition to patient-centered medical homes.

The patient-centered medical homes model is growing and those practices have more non-physician clinicians on staff and higher use of electronic health records.

As of 2013, 18% of office-based primary care doctors in the United States worked in practices certified as PCMHs, according to a new Centers for Disease Control and Prevention report.

Researchers compared PCMH practices—a comprehensive care delivery model which provides team-based care—to traditional practices. The report noted the following differences:

  • Primary care doctors in PCMH practices had at least one physician assistant, nurse practitioner or certified nurse midwife on staff compared to traditional practices (nearly 69% versus 48%).
  • Doctors who were part of a PCHM practice used EHR systems more frequently (94% versus 74%) and provided greater around-the-clock access to patient medical records (91% versus 74%).
  • Doctors in PCMH practices reported electronic transmission as the primary method to receive information on patients hospitalized or seen in emergency departments (nearly 70% versus 41%).
  • More doctors in PCMH practices reported quality measures or indicators to payers or organizations monitoring healthcare quality (nearly 87% versus 70%).

The comparison, however, shows that more primary care practices could become certified as PCHMs, Brian Tsai, spokesman for the National Center for Health Statistics, told MedPage Today.

"The report found that a substantial percentage of non-PCMH practices have non-physical clinicians on staff and use EHR systems. This suggests there is potential for more primary care practices to become certified as a PCMH as ongoing payment incentives from CMS [Centers for Medicare & Medicaid Services], certain payers and states continue to be implemented," he said.

The researchers analyzed data on 1,192 primary care physicians from the 2013 National Ambulatory Medical Care Survey, an annual survey of U.S. office-based physicians that included questions on PCMH status and PCMH-related characteristics for the first time. 

One doctor whose Virginia pediatric practice achieved certification as a PCMH said a practice needs buy-in from providers and the entire staff for a successful transition. The upfront costs for practices to transition to a medical home are hefty, estimated at about $31,000.