Patient-centered Medical Homes and Access to Services for New Primary Care Patients

Abstract

PCMH practices maybe associated with better access to new primary care appointments for nonelderly adults, those most likely to gain insurance under the Affordable Care Act.

Patient experience of general practice and use of emergency hospital services in England: regression analysis of national cross-sectional time series data

“…As a result, many countries have experimented with primary care reform to improve patients’ experiences of healthcare. For example, reform in the USA has focused on the Primary Care Medical Home model, which includes accessibility as a central principle; operational standards require primary care practices to offer appointments in the evenings and at weekends, for example 3. Part of the interest in this model also comes from the hypothesis that more responsive primary care services will reduce use of emergency hospital services 4–9.…”

Organizational Processes and Patient Experiences in the Patient-centered Medical Home

“…This finding supports previous evidence that patients with Medicaid insurance have significantly greater difficulty in accessing primary care services as compared to other insurance types, even among practices that reportedly accept Medicaid, irrespective of the PCMH status of the practice. (40, 41) A follow-up study demonstrated that increased Medicaid reimbursement to primary care providers, as mandated in the ACA, was associated with improved appointment availability for Medicaid enrollees among participating providers without generating longer waiting time. (42) This study highlights financial reimbursements as one modifiable contributor to this disparity.…”

Patient-Rated Access to Needed Care: Patient-Centered Medical Home Principles Intertwined

“…Improving access to care is one of the central goals of the patient-centered medical home (PCMH) model. The model recommends access-related changes aimed at improving appointment availability; accordingly, much research on access and PCMH has focused on administrative indicators of the availability of appointments (Aysola, Rhodes, & Polsky, 2015; Leroux, Cote, Kum, Dabney, & Wells, 2017). However, the patient-centered care team – a core part of PCMH – plays an important role in access to care beyond improving appointment availability: the care team helps patients determine whether and when care is needed, and manages the scheduling of different services, in some cases across several clinicians and settings.…”