The Patient-Centered Medical Home: A Path Toward Health Equity?

Wong, Winston; Anderson, Karen M.; Dankwa‐Mullan, Irene; Simon, Melissa A.; Vega, William A.

doi:10.31478/201209b

Cited by 12 publications

(16 citation statements)

References 6 publications

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“…The association between PCMH status and clinic SDH capacity is consistent with PCMH criteria that recognize clinics that provide community resources and linkages to assist patients with health-related social needs. 28 These 3 factors, social work and pharmacy availability and PCMH recognition, offer concrete policy or intervention targets for health systems seeking to increase clinic SDH capacity, which may, in turn, contribute to decreased burnout.…”

Section: Discussionmentioning

confidence: 99%

Physician Burnout and Higher Clinic Capacity to Address Patients' Social Needs

et al. 2019

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Background: A recent regional study found lower burnout among primary care clinicians who perceived that their clinic had greater capacity to meet patients' social needs. We aimed to more comprehensively investigate the association between clinic capacity to address social needs and burnout by using national data that included a more representative sample of family physicians and a more comprehensive set of practice-level variables that are potential confounders of an association between clinic social needs capacity and burnout. Methods: We conducted a cross-sectional analysis of 1298 family physicians in ambulatory primary care settings who applied to continue certification with the American Board of Family Medicine in 2016. Logistic regression was used to test associations between physician and clinic characteristics, perceived clinic social needs capacity, and burnout. Results: A total of 27% of family physicians reported burnout. Physicians with a high perception of their clinic's ability to meet patients' social needs were less likely to report burnout (adjusted odds ratio [OR], 0.66; 95% confidence interval [CI], 0.47-0.91). Physicians who reported high clinic capacity to address patients' social needs were more likely to report having a social worker (adjusted OR, 2.16; 95% CI, 1.44-3.26) or pharmacist (adjusted OR, 1.73; 95% CI, 1.18-2.53) on their care team and working in a patient-centered medical home (adjusted OR, 1.65; 95% CI, 1.24-2.21). Conclusion: Efforts to reduce primary care physician burnout may be furthered by addressing structural issues, such as improving capacity to respond to patients' social needs in addition to targeting other modifiable burnout risks.

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Section: Discussionmentioning

confidence: 99%

Physician Burnout and Higher Clinic Capacity to Address Patients' Social Needs

et al. 2019

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“…18 It is hypothesized that an expanded medical home model will further decrease health disparities. 19 Ongoing multisite FCMH demonstration projects aim to provide additional evidence regarding the effectiveness of the FCMH model of care. 20 The current scope of practice of the FCMH is deeply rooted in the medical model of care, including child health supervision and acute and chronic disease management occurring primarily at an office site.…”

Section: The Family-centered Medical Homementioning

confidence: 99%

Merging Systems: Integrating Home Visitation and the Family-Centered Medical Home

2013

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To improve the health of children and bend the health care cost curve we must integrate the individual and population approaches to health and health care delivery. The 2012 Institute of Medicine (IOM) report Primary Care and Public Health: Exploring Integration to Improve Population Health laid out the continuum for integration of primary care and public health stretching from isolation to merging systems. Integration of the family-centered medical home (FCMH) and home visitation (HV) would promote overall efficiency and effectiveness and help achieve gains in population health through improving the quality of health care delivered, decreasing duplication, reinforcing similar health priorities, decreasing costs, and decreasing health disparities. This paper aims to (1) provide a brief description of the goals and scope of care of the FCMH and HV, (2) outline the need for integration of the FCMH and HV and synergies of integration, (3) apply the IOM' s continuum of integration framework to the FCMH and HV and describe barriers to integration, and (4) use child developmental surveillance and screening as an example of the potential impact of HV-FCMH integration. Pediatrics 2013;132:S74-S81 AUTHORS:

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“…39,40 Whereas broadly including schools within these models are important, it may be most beneficial in medically underserved communities for schools themselves to serve as the locus of the health home; school-centered health homes may be able to fill access gaps and confront health inequities that are otherwise difficult to surmount. 41 Another opportunity to expand reimbursement to schools lies in a recent Medicaid rule change: as of January 2014, Medicaid will reimburse for preventive services administered by a healthcare worker when these services have been recommended by a physician or other licensed healthcare professional. 42 Previously, Medicaid would reimburse for preventive services only when provided by a licensed healthcare professional.…”

Section: Opportunities For Overcoming Medicaid Reimbursement Challengesmentioning

confidence: 99%