Study: Even small steps toward medical homes improve care

Despite the challenges of a practice overhaul, adoption of the patient-centered medical home model (PCMH) has shown to benefit patients, practices and the health system at large. According to an analysis of Blue Cross Blue Shield of Michigan's PCMH program, for example, practices that fully implemented the model achieved a 3.5 percent higher quality measure, a 5.1 percent higher preventive care measure and a $26.37 lower per member per month medical cost for adults.

As a result, the plan estimated that its PCMH program saved $155 million during its first three years, plus an additional $155 million in the program's fourth year, according to an announcement.

Most encouraging, however, may be researchers' finding that even partial, incremental implementation of PCMH features--such as use of care coordinators and disease registries--can help offices provide higher-quality care at lower cost.

That's good news for the 70 percent of practices surveyed by the Medical Group Management Association who said they were currently working toward becoming medical homes.

For practices that take on this transformation, even small changes can yield substantial improvements in staff and patient satisfaction. For example, at Barre Family Health Center in Massachusetts, which became accredited as a medical home by the National Committee for Quality Assurance in Sept. 2012, patients immediately embraced the addition of private booths off the waiting room that allowed them to speak privately with clinicians, according to the Telegram & Gazette.

With nine physicians and 12 residents treating patients, the Barre Clinic is the only one of six PCMH-certified UMass Memorial medical groups to employ care managers to perform functions such as calling patients who are leaving the hospital to book follow-up appointments or talking to insurers or community organizations on patients' behalf.

"I'm like the liaison between the patient and the doctor, the patient and the psychologist, the patient and any service," Alice M. LeBlanc, R.N., the group's clinical care manager, told the newspaper.

On the flipside of this equation, separate research from the University of California Los Angeles found that at-risk patients without a regular medical home suffered health consequences, the Napa Valley Register reported.

In particular, the study found that Californians with medical homes had the most confidence in their ability to manage their health than those who did not. Those least likely to belong to medical homes, according to the study, were uninsured patients, Latinos and those receiving care from nonconventional providers.

While the lack of a medical home may not be detrimental to a patient who is young and healthy, according to researchers, it's a problem when patients suffering from chronic conditions only see a doctor for emergencies, with no one coordinating their care.

"We know when patients jump from provider to provider, their care is not as good," Tanir Ami, CEO of Napa County's Clinic Ole, told the newspaper.

To learn more:
- see the announcement from Blue Cross Blue Shield of Michigan via the Wall Street Journal
- read the article from the Telegram & Gazette
- here's the article from the Napa Valley Register

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