Improved Care and Reduced Costs Associated with Patient-Centered Medical Homes

Orlando—In recent years, 18 states have implemented a total of 27 large multistakeholder pilot programs examining patient-centered medical homes (PCMHs). The District of Columbia and 44 states have passed >330 laws related to PCMHs. So far, many of the initiatives have shown promising results, although it remains to be seen if PCMHs will be able to improve healthcare quality and reduce costs, according to Steve Casebeer, MBA, executive vice president of Impact Education, LLC. Mr. Casebeer made a presentation about PCMHs at the NAMCP meeting in a session titled Patient-Centered Medical Home: Implementation of a New Paradigm of Care. Mr. Casebeer discussed principles drafted in February 2007 regarding PCMHs from 4 primary care physician organizations: American Osteopathic Association, American Academy of Family Physicians, American Academy of Pediatrics, and American College of Physicians. The principles included an ongoing relationship with a personal physician, a physician-directed medical practice, coordinated care, focus on quality and safety measures, enhanced access to care, and a payment method that recognizes the value physicians provide in PCMHs. Of the PCMH programs already in place, several have been successful, according to Mr. Casebeer. At the Group Health Cooperative in Seattle, Washington, the PCMH has led to a 29% reduction in emergency department visits. Since adopting a PCMH model, the Geisinger Health System in Pennsylvania has seen a 20% reduction in hospitalizations. In addition, Intermountain Healthcare in Salt Lake City, Utah, has saved $640 per patient enrolled in PCMHs. Mr. Casebeer also said there has been an increased emphasis on PCMHs in medical schools and residency programs. Among the major advocates for PCMHs is the Patient-Centered Primary Care Collaborative (PCPCC), an organization established in 2006 to improve relations between patients and physicians as well as improve the effectiveness and efficiency of healthcare delivery. Mr. Casebeer said the PCPCC has >750 active members and >3000 participants. The organization has 9 task forces focused on different aspects of promoting PCMHs, including an education and training group that supports the training of PCMH-ready clinicians and links education and training into payment reform. Through its research, the PCPCC identified several ways to develop PCMHs, with a focus on making comprehensive medication management the standard of care. For instance, the guidelines suggest that medications are assessed to determine if they are safe, appropriate for the patient, effective for the medical condition, and able to be taken as intended. Because traditional care for chronic illness does not include integrated medication management, the PCPCC has also identified the need to identify and describe the services, workflow processes, and evaluation methods associated with medication management in PCMHs. The organization believes medication management services are crucial to a PCMH’s ability to provide better outcomes, according to Mr. Casebeer.