In our scattered healthcare system, the patient-centered medical home model has risen to the surface as a way to practice primary care in a completely revolutionized way.
The patient-centered medical home is a transition away from symptom and illness-based care, and into a system of comprehensive coordinated care. It’s an ongoing, active partnership with a primary care physician who leads a team of professionals and provides proactive, preventative and chronic care management. The physician also coordinates a patient’s care across the whole healthcare system, which has proven to be remarkably successful.
Patient-centered medical homes also fit into the now-popular direct primary care model, Dr. Amy Mullins says. Mullins is the medical director for quality improvement at the American Academy of Family Physicians, and she specializes in transitioning practices into a patient-centered medical home model. Direct primary care is at its core a patient-centered medical home- based delivery model, according to Mullins. The two models share major tenants like access and team care, but direct primary care practices offer more access, longer visits and fewer patients.
The patient-centered medical home model has gained traction over the past decade, with 8,000 practices recognized as medical homes since 2008, according to the NCQA. Even with the number of medical homes on the rise, though, transitioning traditional practices to the patient-centered medical home model can appear to be a daunting task. Mullins points out that there’s no cookie-cutter transformation method when it comes to re-directing care either, because each clinic has their own norms, norms that depend on the community and population.
“Transforming to a patient-centered medical home is a journey, not a destination,” Mullins says. “There is no one-size-fits-all approach to transformation. The path one takes on the journey depends on where one starts.”
There are, however, several innovations that have been successful in Mullins’ work, although there’s much work still to be done. She says that these innovations include expansion of access, patient engagement and empowerment, and, on a smaller scale, risk-adjusted payment and share savings initiatives.
“A most innovative medical homes offer non-traditional clinical encounters like e-visits, group visits, health coaching, tele-health and the use of patient portals,” she says. “They also solicit patient input on how the practice is run, too. Patient and family advisory panels can help practices identify and implement innovative processes, improving work flow and overall patient-centeredness in the practice.”
Mullins also notes that one of the biggest innovations she’s seen is just the transformation to this model in and of itself. “Completely changing the way primary care and patient-centered medical homes are valued is a larger innovation than most people realize,” she says. “Public and private payers are making progress in this regard, but it has been slow. Paying for value over volume will need to be the way of the future.”
Ultimately, a few big factors lead to the success of patient-centered medical homes: physician buy in and payment reform. “Most successful medical homes are led by physicians who play an active role in transformation and sustainability,” Mullins says. “But for changes to be sustainable, there needs to be fair and adequate payment. Physicians and their staff cannot continue to do more with less.”
Patient-centered medical homes will be one point of discussion at our September 16 event, Medicine on the Front Lines: Empowering the Next Generation of Primary Care Providers.
Jenni Whalen is the Executive Assistant of Editorial at Upworthy. She was previously MedTech Boston's Managing Editor and has an MS in Journalism from Boston University, as well as a BA in Psychology from Bucknell University. Whalen has written for Greatist, Boston magazine, AZ Central Healthy Living and the New England Journal of Medicine, among other places. She has also worked as a conference planner, ghost writer, researcher and content developer.
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