The patient-centered medical home (PCMH) has shown great promise in lowering costs and improving care at facilities with the wherewithal to implement it, but the transition has been a challenge for smaller organizations lacking significant resources. However, a new study out of the University of California Los Angeles and the University of Southern California suggests the PCMH is not only possible in an urban, safety-net setting, but also can be a big success.
The Galaxy Health program, debuted at Los Angeles County+USC Medical Center (LAC+USC) in 2012 and funded primarily by a three-year, $750,000 grant from UniHealth Foundation, proved that intuitive and inexpensive interventions improve patient care and physician and staff morale, according to an announcement from the University of Southern California.
"My hope was that Galaxy would reveal that a minimal investment and reorientation in delivery focused on the patient and enhanced access to care could improve the satisfaction of patients, staff and physicians, even in an underfunded public environment," said David Goldstein, M.D., chief of the division of geriatric, hospital, palliative and general internal medicine at LAC+USC Medical Center, who conceived the Galaxy Health program.
The Galaxy model provided round-the-clock, seven-day-a-week access to physicians, urgent clinic appointments available within hours and coordinated, team-based care in the ambulatory environment but has not yet reduced emergency department or hospital utilization (an outcome researchers expected in the underserved population they studied). However, the program achieved the following results:
- The Galaxy clinic drew much closer to qualifying as a certified PCMH, raising its score from 35 to 53 out of 100 possible points.
- The satisfaction rating from patients in the intervention group jumped from 48 percent to 65 percent, compared with a rise from 50 percent to 59 percent in the control clinic.
- Satisfaction with urgent appointment scheduling increased from 12 percent to 53 percent in the intervention clinic versus 14 percent to 18 percent in the control clinic.
- The composite satisfaction score for residents rose from 39 percent to 51 percent in the intervention clinic, but fell in the control clinic from 46 percent to 42 percent.
The Galaxy program isn't full-fledged, certified PCMH, but it can still start seeing similar results, as partial, incremental implementation of medical home features, such as use of care coordinators and disease registries, can lead to high-quality, low-cost care, according to a July analysis of Blue Cross Blue Shield of Michigan's PCMH program.
To learn more:
- see the announcement from the University of Southern California