Although supporters of the concept have touted the patient-centered medical home as a way to help pull together a fragmented system of delivering primary care in the United States, a report in the June issue of Oncology describes how the concept applied to cancer care is cutting costs, reducing hospitalizations, and providing greater accountability for care delivery.
Consultants in Medical Oncology and Hematology, PC (CMOH), a private practice in southeastern Pennsylvania, has become the first oncology practice in the nation to achieve level III recognition from the National Committee for Quality Assurance as an oncology patient-centered medical home (OPCHM).
As with its cousin in primary care, the cornerstone of the OPCHM is that a physician-led care team manages each patient. However, CMOH's nine physicians have an extensive support team, with several advanced practitioners on staff to help coordinate each patient's care. While a patient's relationship with the practice doesn't begin until he or she is diagnosed with a malignancy, CMOH serves as the central coordinator of care throughout all phases of treatment and into survivorship. While the patient's PCP continues to manage many non-oncologic medical issues during this time, communication between the primary care and oncology teams is of utmost importance.
Although study authors David Eagle, MD, and John Sprandio, MD, acknowledged that there are few metrics available to evaluate outcomes under the model, CMOH has already made several measurable improvements in care delivery. For example, the group's enhanced telephone triage has allowed patients to manage their symptoms at home for three quarters of their clinical calls to the practice. On average, a CMOH chemotherapy patient visits the ER just once per year--half the rate reported in another large commercially insured population, and 65 percent lower than the practice's own rate in 2006. In addition, CMOH's rate of hospitalizations per chemotherapy patient per year has dropped by 43 percent since 2007.
According to Drs. Eagle and Sprandio, it will be the role of medical oncologists to ensure this model survives in a changing health environment in which quality care parameters for ongoing cancer care have been largely overlooked. "We believe that physician-led change will lead to optimal outcomes since it is physicians who best understand the needs of patients and the actual process of care delivery," they wrote.
To learn more:
- read the Oncology study via cancernetwork.com