What is a Patient-Centered Medical Home?

While the words “patient-centered medical home” (PCMH) sound like a place or location, PCMH is actually much more. PCMH is a distinctive way to practice medicine and interact with patients. The idea of PCMH originated in 1967 when the American Academy of Pediatrics introduced the medical home concept to coordinate the care of children with chronic conditions. All information related to a child’s care was stored in a central location, and one physician oversaw all care provided to the child. Forty years later, in 2007, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, and the American Osteopathic Association together issued Joint Principles of the Patient Centered Medical Home.

 

These Joint Principles called for a delivery of health care that centered on the choice of a personal physician in a physician directed medical practice oriented toward providing care to the whole person. Additional hallmarks of the Joint Principles were care coordination across the health care system, quality and safety of the care provided, enhanced access for patients, and payment reform commensurate with the different method and enhanced care provided to patients. In sum, a PCMH is a way of doing primary care that structures a physician practice around the needs of the patient. At the same time, many of the implementations will result in a more stream-lined practice leading to increased physician and employee satisfaction. Many practices are already a PCMH, and many others can be a PCMH with just a few adjustments.

 

Do patient-centered medical homes work?

 

Published and ongoing research suggests that PCMH works, with the following being the most cited benefits for practices that embrace PCMH:

 

  1. Improved patient experience

  2. Reduced clinician burnout

  3. Reduced hospitalization rates

  4. Reduced ER visits

  5. Increased savings per patient

  6. Higher quality of care

  7. Reduced cost of care

 

Significantly, one of the main tenets of NCQA PCMH is patient self-care management. Often physicians are rightfully frustrated by patients who are not compliant with a care plan. NCQA PCMH addresses this head on, with new ideas and a structured approach to helping patients help themselves. PCMH will not work without physician and staff commitment to the practice transformation. But with a committed staff led by physicians, and with help from the SCMA and other sources of assistance, a practice should see both instant and long-term results from its efforts to become a PCMH. In many cases, practices are already doing much of what is required, and the process will involve memorializing these practices and reporting for NCQA recognition. Others have not taken many steps towards PCMH, but it is not too late to get started. In either case, the SCMA is committed to providing the level of assistance necessary for physician practices to achieve their PCMH goals.

© 2014 by South Carolina Medical Association.