The Advisory Board recently asked this question: Are patient-centered medical homes (PCMHs) living up to the hype? As Tomi Ogundimu and Abby Burns wrote, the concept’s popularity has increased since passage of the Affordable Care Act and a shift to value-based payment for health care providers.
Ogundimu and Burns referenced a recent report from the Patient-Centered Primary Care Collaborative, which found that PCMHs can help improve the quality of care can take time to deliver a return on investment. That means this model may not lower costs right away.
As Lola Butcher notes in a new AHCJ tip sheet, thousands of primary care physician practices have organized themselves into PCMHs, making this model the most widespread type of reform of care delivery and payment. “The concept is likely to become even more popular in the years ahead because the federal government’s Quality Payment Program included some medical home practices to be in an advanced alternative payment model (APM), making them eligible for incentive payments,” Butcher writes.
In the tip sheet, she outlines how primary care medical homes work and explains that many specialty physicians, including oncologists and gastroenterologists, are organizing into medical homes as well.
Health care journalist Tracey Walker has covered this development for Modern Medicine. “A new value-based cancer care model is focusing on better aligning providers with health plans and employers through an independent practice association (IPA) structure that creates patient-centered medical homes,” Walker wrote.
In an article for Managed Care magazine, Butcher interviewed John Sprandio, M.D., an oncologist and hematologist who helped to develop an oncology patient-centered medical home. “At every opportunity, Sprandio pointed out that running an oncology medical home practice is much more expensive in the short term than traditional cancer care and, at least initially, providers would be footing the bill,” she wrote.
As a result of the work of Sprandio and others, health insurers see the value in medical homes, as Health Care Finance News reported in 2015. The article described an effort by Aetna and the Moffitt Cancer Center in Tampa to establish an oncology medical home to help control costs, reduce clinical inefficiency and duplication of services, and to make it easier for Aetna’s members with cancer to get better access to care.
Indeed, one of the attributes of medical homes is that they can reduce the time patients wait for appointments, in part because physicians in medical homes have highly trained support staff such as physician assistants and nurse practitioners who provide much of the patient care. Using mid-level staff in this way helps keep patients out of the emergency room and avoid hospitalizations, two of the costliest settings for care, Sprandio has said.
Full disclosure: I have been in a PCMH since 2013 and have had no trouble getting an appointment on short notice because almost every time I’ve seen a nurse practitioner. I’ve met my physician just once, when I had a Saturday morning appointment. To date, I have been very satisfied with my care.