Despite the challenges practices face in implementing the patient-centered medical home (PCMH) model, many who've put forth the effort have achieved promising results, according to a series of recent reports. However, progress to date varies by practice size, noted an article from Medscape.
Small to medium-size practices, for example, increased use of nurse managers and nonphysician staff, according to a review of three separate studies published in Health Affairs, but lagged behind larger groups in offering group visits for patients and having electronic access to hospital records.
Overall, the research echoed previous studies showing that there is no one-size-fits-all approach to creating an effective PCMH. However, a study published last month in the American Journal of Managed Care concluded that not only could preventive care be vastly improved using elements of the PCMH model, but also that other care settings could duplicate the approach used in the busy, urban settings studied.
One of the strengths of the pilot program was its use of team-based care. As described by an article in HealthIT Analytics, researchers from New York University designed personalized care programs for study patients that included 40 to 60 minute visits, split between a registered nurse and a care coordinator with physician oversight.
The extended visits did not result in serious disruptions to workflow, however, because each patient's time was spread across members of the care team, according to the article. The benefits, meanwhile, were significant and included an average increased life expectancy of 12 months compared to just 6.7 months under a traditional model, as well as improvements in smoking cessation, weight control and hypertension management. "The reduction in long-term costs due to patient health gains more than made up for any productivity losses incurred by the length of the consults," the authors noted.