What is a Patient Centered Medical Home (PCMH)?

The Patient Centered Medical Home (PCMH) model of care delivery has been in the media lately as one of the solutions to the access problems and high cost of health care in the U.S. Holland PHO and several PHO primary care practices have been working collaboratively with Priority Health and Blue Cross Blue Shield (BCBSM) for the past several years to bring the PCMH concept to the Holland community.

The Patient Centered Medical Home is a system of providing primary care that incorporates changes in almost every aspect of primary care and almost every area of a primary care office. The aim of this system is to improve the quality and efficiency of medical care, to enhance the patient-physician relationship, and to improve the patient’s satisfaction, the physician’s satisfaction, and the practice staff’s satisfaction with the primary care practice.

Patient-Centered Medical Home encompasses the following principles:

• each patient receives care from a personal physician;
• the personal physician leads a team of providers who are responsible for the patient’s ongoing care;
• the personal physician is responsible for the “whole person”;
• patient care coordination and nurse care management;
• a patient’s care is coordinated across the health system and community;
• each patient is educated and counseled to self-manage their own health and disease care with the support of their physician–led care team;
• quality and safety are hallmarks of the practice, based on evidenced-based medicine guidelines;
• enhanced access to care is offered through open scheduling, expanded hours, and new care options such as group visits, telephone visits, and e-visits;
• health information technology support is used to and enhance patient care: and,
• payment that appropriately recognizes the added value provided to patients who have a patient-centered medical home.  

The patient centered medical home promises to change the status quo by enabling physicians to provide comprehensive primary care through stronger partnerships with their patients. PCMH is a model of care that holds significant promise for better health care, improved involvement of patients in their own care, and reduced avoidable costs over time. PCMH seeks to strengthen the physician-patient relationship by replacing episodic care based on illnesses and patient complaints with coordinated care and a long-term healing relationship.

The American College of Physicians, the American Academy of Family Practice, the American Academy of Pediatrics, and the America Osteopathic Association have jointly defined the medical home as a model of care where each patients has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care. The physician-led care team is responsible for providing for all the patient’s health care needs and, when needed, arranges for appropriate care with other qualified physicians.

PCMH is an ongoing process or journey, not a destination. It is a commitment to improving care through successive changes to the systems within a practice. The system for making appointments, through-put of patients, follow up “tickler” files, use of technology, patient education, and many other components of the practice are evaluated and changes are made as appropriate, with the goal of improvement, efficiency, and satisfaction.

Holland PHO provides support to PHO primary care practices on this PCMH journey and is an active participant in BCBSM and Priority Health pilot programs to implement PCMH in the Holland area.

There have been numerous PCMH pilot and demonstration projects across the United States, including those planned by CMS Medicare, Aetna and Partners in Care, GIGNA Dartmouth Hitchcock, and IBM and United Health Care. Interest and support for the PCMH model of care comes from national health plans, large national employers, and the federal government. The patient centered medical home as a building block for our health care system is a concept that is capturing the attention of leaders and experts throughout the medical community.

For additional information about PCMH, see the following web sites:

http://www.transformed.com/       

http://www.acponline.org/advocacy/where_we_stand/medical_home/resources.htm

http://www.medicalhomeforall.com/

http://www.ghc.org/GettingCare/MedicalHome.jhtml