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Primary Care Innovation: The Patient-Centered Medical Home

Monday, September 22, 2008

It is widely accepted that the U.S. health care system, although touted by some as the “best system in the world,” has room for improvement. Many people have no regular health care provider. Care is often fragmented and lacks coordination, which compromises quality and efficiency. Incentives for providers have not caught up with the demographics of chronic care. Some 75 percent of Medicare spending is on beneficiaries with five or more chronic conditions – and those people see an average of 14 different physicians a year.

Medicare demonstration projects and private sector initiatives are testing models that promise to improve health outcomes, decrease health disparities and enhance patient experience. These are patient-centered primary care models referred to as “medical homes,” which are designed to manage chronic care and realign incentives.

Can health care be refocused from acute care services to the management of chronic conditions? Is payment reform the first step in restructuring health care delivery? What part can private integrated delivery systems play? Are different models needed in large group practices and smaller ones? What challenges face policymakers in the current climate of health care reform?

To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund sponsored a September 22 briefing. Panelists were: Robert Berenson, Urban Institute; Diane Rittenhouse, University of California San Francisco; and Duane Davis, Geisinger Health System. Melinda Abrams of Commonwealth and Ed Howard of the Alliance co-moderated.


 Melinda Abrams, The Commonwealth Fund, Moderator
 Ed Howard, Alliance for Health Reform, Moderator
 Robert Berenson, Urban Institute, Speaker
 Diane Rittenhouse, University of California San Francisco, Speaker
 Duane Davis, Geisinger Health System, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Primary Care Innovation: The Patient-Centered Medical Home (Adobe Acrobat PDF), 9/22/2008
Event Summary: Primary Care Innovation: The Patient-Centered Medical Home (Word Document), 9/22/2008
Full Webcast/Podcast: Primary Care Innovation: The Patient-Centered Medical Home

The transcript, full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Abrams Presentation (PowerPoint), 9/22/2008
Berenson Presentation (PowerPoint), 9/22/2008
Davis Presentation (PowerPoint), 9/22/2008
Rittenhouse Presentation (PowerPoint), 9/22/2008

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Primary Care Innovation: The Patient-Centered Medical Home (Word Document), Microsoft Word, 9/22/2008
Sourcelist (Adobe Acrobat PDF), , 9/22/2008

Offsite Materials (briefing documents saved on other websites)

A 2020 Vision of Patient-Centered Primary Care, The Commonwealth Fund, 10/14/2005
Organizing the U.S. Health Care Delivery System for High Performance, The Commonwealth Fund, 8/7/2008
New Survey: 82 Percent of American Think Health Care System Needs Major Overhaul, The Commonwealth Fund, 8/7/2008
Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive C, The Commonwealth Fund, 3/15/2007
Toward Higher-Performance Health Systems: Adults' Health Care Experiences in Seven Countries, 2, The Commonwealth Fund, 11/1/2007
Testimony--Achieving Person-Centered Primary Care: The Patient-Centered Medical Home, The Commonwealth Fund, 7/28/2008
Closing the Divide: How Medical Homes Promote Equity in Health Care: Results From The Commonwea, The Commonwealth Fund, 6/27/2007
Joint Principles of the Patient-Centered Medical Home (Adobe Acrobat PDF),American Academy of Pediatrics, 3/1/2007
Patient-Centered Medical Home Model Position Statement , American College of Emergency Physicians, 8/13/2008
AHIP Board of Directors Releases Principles on Patient-Centered Medical Home, America's Health Insurance Plans, 6/25/2008
‘Medical home’ shifts emphasis to patient-centered care, Business Insurance, 3/10/2008
Getting What We Pay For: Innovations Lacking in Provider Payment Reform for Chronic Disease Car, Center fo rStudying Health System Change, 6/1/2008
Healthcare Payment Reform: From Principles to Action, Healthcare Financial Management Association, 6/1/2008
Who not How: The Real First Step in Health Care Reform, Manhattan Institute, 7/31/2008
Physician Practice Connections- Patient-Centered Medical Home, National Committee for Quality Assurance, 1/8/2008
Healthcare Payment Reform: Creating Conditions for More Efficient Health Delivery (Adobe Acrobat PDF),The Health Industry Forum, 4/10/2008
Health Care Reform: Design Principles for a Patient-Centered, Consumer-Based Market, the Heritage Foundation, 4/23/2008
A House Is Not A Home: Keeping Patients At The Center Of Practice Redesign, Health Affairs, 9/10/2008
Continuous Innovation In Health Care: Implications Of The Geisinger Experience, Health Affairs, 9/10/2008
Measuring The Medical Home Infrastructure In Large Medical Groups, Health Affairs, 9/10/2008
The Need to Test the Patient-Centered Medical Home, The Journal of the American Medical Association, 8/20/2008
Trying to Save by Increasing Doctors' Fees, The New York Times, 7/21/2008
No Place Like Home — Testing a New Model of Care Delivery, The New England Journal of Medicine, 9/18/2008
Building a Medical Neighborhood for the Medical Home, The New England Journal of Medicine, 9/18/2008
Patient Centered Medical Home: Highlights (Adobe Acrobat PDF),American Academy of Family Physicians, 1/11/2008
Integrating the Patient Centered Medical Home into a Health Reform Proposal, Patient-Centered Primary Care Collaborative, 6/23/2008
Patient-Centered Primary Care Collaborative (Adobe Acrobat PDF),Patient-Centered Primary Care Collaborative, 1/1/2008


Melinda Abrams of The Commonwealth Fund, co-moderator of the Sept. 22 briefing co-sponsored by the Fund.

Robert Berenson of the Urban Institute outlines the benefits of medical homes, and some barriers to wider adoption of the idea. (13 min.) From the Sept. 22 briefing co-sponsored by The Commonwealth Fund.

Dr. Diane Rittenhouse of the Univ. of Calif. - San Francisco reports on which medical practices best meet the criteria for medical homes. (12 min.) From the Sept. 22 briefing co-sponsored by The Commonwealth Fund.

Duane Davis, VP and chief medical officer of the Geisinger Health Plan, describes Geisinger's approach to medical homes -- called the Proven Health Navigator program. (13 min.) From the Sept. 22 briefing co-sponsored by The Commonwealth Fund.


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