Patient Experience with the Patient-Centered Medical Home in Michigan’s Statewide Multi-Payer Demonstration: A Cross-Sectional Study

Sarinopoulos, Issidoros; Bechel-Marriott, Diane L.; Malouin, Jean M.; Zhai, Shaohui; Forney, Jason; Tanner, Clare

doi:10.1007/s11606-017-4139-2

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…PCMH initiatives sup ported by public payers include Medicare's Comprehensive Primary Care Initiative (CPC), Comprehensive Primary Care Plus (CPC+), the Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration, and the Medicaid Health Homes State Option. In recent years, there has been a growth in private and multipayer PCMH initiatives as well (Carrillo et al, 2014;Friedberg, Schneider, et al, 2014;Cole et al, 2015;Takach et al, 2015;Sarinopoulos et al, 2017). The majority of PCMH models remain focused on primary care, but recently there has been more experimentation with "intensive medical homes" and "specialty medical homes" for patients with advanced chronic illness who require close follow up by specialists (Walker, 2017).…”

Section: Patient-centered Medical Homes Prevalencementioning

confidence: 99%

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Friedberg¹,

Chen²,

Simmons³

et al. 2018

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Section: Patient-centered Medical Homes Prevalencementioning

confidence: 99%

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Friedberg¹,

Chen²,

Simmons³

et al. 2018

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“…However, PCMH research most often focuses on system-level indicators (eg, shifts in healthcare use). 1 Research highlighting the patient perspective is more sparse and commonly limited in scope, 13 , 14 including a focus on priorities and preferences for transformed practices rather than actual experience, 15 - 17 few elements of the model, 1 , 18 patients with specific health conditions, 11 , 18 and/or reporting survey data, 19 , 20 without the nuance offered by qualitative methods. Results are unclear, 5 , 14 , 21 with some research suggesting PCMH recognition improves patient experience, 19 , 21 while other studies suggesting there is no difference between PCMH and non-PCMH providers.…”

Section: Introductionmentioning

confidence: 99%

“…In an effort to address the gaps in the literature-and to contribute to the growing body of evaluations [19][20][21][22] of largescale PCMH expansion-the current study, which was part of a statewide, mixed-methods evaluation of the NY SIM, 10 explores experience and perspectives regarding PCMH implementation and PCMH core components from a diverse population of NYS PCMH patients and providers.…”

Section: Introductionmentioning

confidence: 99%

Transforming Primary Care in New York Through Patient-Centered Medical Homes: Findings From Qualitative Research

Weiss

Griffin

et al. 2022

J Prim Care Community Health

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Background: The patient-centered medical home (PCMH) model, an important component of healthcare transformation in the United States, is an approach to primary care delivery with the goal of improving population health and the patient care experience while reducing costs. PCMH research most often focuses on system level indicators including healthcare use and cost; descriptions of patient and provider experience with PCMH are relatively sparse and commonly limited in scope. This study, part of a mixed-methods evaluation of a multi-year New York State initiative to refine and expand the PCMH model, describes patient and provider experience with New York State PCMH and its key components. Methods: The qualitative component of the evaluation included focus groups with patients of PCMH practices in 5 New York State counties (n = 9 groups and 67 participants) and interviews with providers and practice administrators at New York State PCMH practices (n = 9 interviews with 10 participants). Through these focus groups and interviews, we elicited first-person descriptions of experiences with, as well as perspectives on, key components of the New York State PCMH model, including accessibility, expanded use of electronic health records, integration of behavioral health care, and care coordination. Results: There was evident progress and some satisfaction with the PCMH model, particularly regarding integrated behavioral health and, to some extent, expanded use of electronic health records. There was less evident progress with respect to improved access and reasonable wait times, which caused patients to continue to use urgent care or the emergency department as substitutes for primary care. Conclusions: It is critical to understand the strengths and limitations of the PCMH model, so as to continue to improve upon and promote it. Strengths of the model were evident to participants in this study; however, challenges were also described. It is important to note that these challenges are difficult to separate from wider healthcare system issues, including inadequate incentives for value-based care, and carry implications for PCMH and other models of healthcare delivery.

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“…Quantitative studies to date have shown mixed but promising results. [3][4][5][6][7] Qualitative research allows for more in-depth exploration and deeper understanding of patients' experiences of care, but little work has been done in this area.…”

Section: Introductionmentioning

confidence: 99%

Patients’ and Caregivers’ Experiences with the Multi-Payer Advanced Primary Care Practice Demonstration

2020

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BACKGROUND: The patient-centered medical home (PCMH) model aims to improve primary health care using a patient-centered approach. Little qualitative research has investigated how the PCMH model affects patient experience with care. OBJECTIVE: To understand Medicaid and Medicare patient and caregiver experiences with PCMHs participating in the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration. DESIGN: Qualitative study. PARTICIPANTS: Medicare, Medicaid, and dually eligible patients who were patients in primary care practices participating in the MAPCP Demonstration and caregivers of such patients (N = 490). APPROACH: From July through November 2014, a trained facilitator conducted 81 focus groups in the eight states participating in the MAPCP Demonstration. Separate groups were held for Medicare high-risk, Medicare low-risk, Medicaid, and dually eligible beneficiaries, their caregivers, and caregivers of Medicaid children (or, in Vermont, with patients participating in the Support and Services at Home program), in two different geographical areas in each state. Focus group discussions were recorded, transcribed, and analyzed using NVivo qualitative data analysis software. RESULTS: Participants' experiences with care were generally consistent with the expectations of a PCMH, although some exceptions were noted. Medicaid only and dually eligible beneficiaries generally had less-positive experiences than Medicare beneficiaries. Most participants said their practices had not solicited feedback from them about their experiences with care. Few participants knew what the term "medical home" meant or were aware that their practices were working to become PCMHs, but many had noticed changes in recent years, primarily related to the conversion to electronic health records. CONCLUSIONS: Most participants had positive experiences with their care. Opportunities exist, however, to improve care for Medicaid and dually eligible beneficiaries, and enhance patient awareness of and involvement in PCMH practice transformation.

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Patient Experience with the Patient-Centered Medical Home in Michigan’s Statewide Multi-Payer Demonstration: A Cross-Sectional Study

Cited by 10 publications

References 21 publications

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Effects of Health Care Payment Models on Physician Practice in the United States: Follow-Up Study

Transforming Primary Care in New York Through Patient-Centered Medical Homes: Findings From Qualitative Research

Patients’ and Caregivers’ Experiences with the Multi-Payer Advanced Primary Care Practice Demonstration

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