Deloitte finds barriers to medical home implementation

A new issue brief by Deloitte Consulting concludes that implementing a patient-centered medical home can pay off by significantly lowering costs, but executing such an initiative often faces cultural resistance.

The report listed 38 medical home pilot programs launched throughout the United States since 2006. According to Deloitte, 54 percent are focused on treating specific chronic diseases.

Deloitte also studied the results of seven medical home programs, including ones launched by Intermountain Health Care in Utah and Community Care of North Carolina's Medicaid program. They were able to reduce hospitalizations from 4.8 percent to 40 percent, and save up to $640 per patient in treatment costs.

However, implementing a patient-centered medical home came with both high start-up and maintenance costs, according to the report, particularly in increased utilization of healthcare information technology and carefully coordinating care teams.

The report also noted that there were many cultural challenges to implementation, with barriers presented by both physicians and patients. "Practices had to shift from physician-centered to patient-centered care--a difficult transition for physicians used to being responsible for the entire patient encounter," concluded the report. Yet "patients did not perceive the transformation to be beneficial, likely because of disruption in the practice and a lack of communication about the benefits of a medical home."  

For more:
- read the Deloitte report
- here's the EHR Watch blog post

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