A Nationwide Survey of Patient Centered Medical Home Demonstration Projects

Abstract

Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows.

Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

“…3 Thus, it is possible that the HITECH Act may have accelerated the existing trend in physician adoption, in addition to being influenced by market forces, state health information technology (IT) initiatives, and health care delivery and payment reform mechanisms which involve the use of EHRs. 2,16,17 Some of these forces driving EHR adoption may affect primary care physicians in particular. An examination of trends prior to 2007 indicates that primary care adoption rates were lower than specialists.…”

“…These differences may reflect in part the early efforts of the Regional Extension Centers (RECs) in promoting EHR adoption among primary care physicians; the particular Medicare and Medicaid eligibility requirements for MU; and the proliferation of health care delivery redesign efforts, such as the Patient Centered Medical Home, which focus on primary care physicians and require the use of health IT. 11,16,[20][21][22] The increased number and types of functionalities adopted by primary care physicians in comparison to specialists in 2011 may place them in a better position to qualify for financial incentives and reap other benefits. Physicians using EHRs with advanced functionalities have reported greater benefits from using EHRs.…”

Do medical residents perform patient-centered medical home tasks? A mixed-methods study

“…The patient-centered medical home (PCMH) model has been adopted by practices and health systems across the country as a way to provide care which better meets the needs of patients than traditional models [1]. PCMH models have been associated with improvements in patient satisfaction and provider burnout, as well as more modest changes in clinical outcomes [2–7].…”

Transforming Primary Care Training—Patient-Centered Medical Home Entrustable Professional Activities for Internal Medicine Residents

“…9 In 2009, there were 94 PCMH demonstration projects involving 14,000 physicians and 5 million patients; 26 projects in 18 states included payment reform. 10 While large-scale patient outcomes remain unchanged, some have demonstrated improved specific chronic condition patient outcomes, decreased provider burn-out, and increased patient satisfaction. [11][12][13][14] Redesigning the primary care work environment has widened the gap between typical residency ambulatory training and the knowledge, skills, and attitudes essential for work in a PCMH.…”

“…The group refined this list through review of published descriptions of PCMH. [8][9][10] We then categorized these EPAs using the 2011 National Committee for Quality Assurance (NCQA) PCMH standards: 1) Enhance access and continuity, 2) Identify and manage patient populations, 3) Plan and manage care, 4) Provide self-care and community support, 5) Track and coordinate care, and 6) Measure and improve performance. 38 We chose the NCQA standards to expand our thinking beyond traditional educational frameworks.…”