Primary care practices need financial support for PCMH transformation

By Aine Cryts

The costs for practices to get set up as patient-centered medical homes (PCMH) are hefty. The upfront costs are just shy of $31,000--or about $9,800 per clinician and $8 per patient, according to a recent study published in the Journal of General Internal Medicine.

Designed to improve the quality of patient care and reduce unnecessary care, PCMHs are primary care practices that are organized around using patient registries, electronic health records and other technologies to provide comprehensive, team-based care to patients.

It's not just the initial costs of PCMH transformation that are so high. The ongoing costs can be as much as $148,000 each year--or about $65,000 per clinician and $30 per patient. The article highlights that initial costs can vary widely--from about $7,700 to $118,000 per practice, with ongoing annual costs that range from $84,000 to a whopping $347,000 per practice.

Researchers surveyed leaders from 12 primary care practices that transformed into PCMHs for three years as part of the Pennsylvania Chronic Care Initiative, a large multipayer medical home pilot.

Some additional findings include:

  • While practice leaders agree that strategic investments in information technology were integral to delivering high-quality patient care, only four practices made PCMH-specific technology investments
  • The single highest ongoing cost was associated with hiring one or more care managers to help coordinate patient care
  • While increasing access for patients is important, only three of the 12 practices expanded their service hours

"Our findings provide one of the best insights to date about the costs associated with medical home transformation," Grant Martsolf, the study's lead author and a policy researcher at RAND, said in a study announcement. "These findings should help guide policymakers as they look for ways to encourage more medical practices to make this transition."

The process of applying for PCMH recognition through the National Committee for Quality Assurance or another accrediting body is an additional expense physician practices carry. Many small practices that have successfully transformed into PCMHs were able to tap into services provided by their regional extension centers, FiercePracticeManagement reported previously.

To learn more:
- read the study abstract
- see the announcement

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