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Patient-Centered Medical Homes: Do They Work?

Friday, May 03, 2013

The federal government has launched demonstration projects to test whether patient-centered medical homes (PCMHs) can tackle some of the biggest problems facing the nation’s health care system. Advocates are holding out hope that medical homes will help to slow the growth of health care spending while improving the quality of care. The medical home is a model that aims to transform the organization and delivery of primary care. The PCMH model focuses on personalized care, teamwork, and coordination of care to ensure that patient needs are met effectively and efficiently. The Patient Protection and Affordable Care Act (ACA) provides opportunities for the PCMH model by supporting nationwide medical home demonstration projects administered by the Center for Medicare and Medicaid Innovation (CMMI).

Why are we investing in testing the patient-centered medical home model? What does current evidence say about the impact of PCMH models? Can these models generate savings for the health care system down the road? Do primary care practices have the capacity and time to develop these models? What resources are necessary to ensure a functioning PCMH?  What is the status of the demonstration projects run under CMMI? What are some successes and challenges that active PCMHs have encountered? How else does the ACA provide support for patient-centered medical homes?

A distinguished panel of experts addressed these and related questions.

Meredith Rosenthal, professor of health economics and policy at Harvard University, discussed results from her latest evaluation of PCMHs and highlighted what is already known and what more we need to know about these models.

Sean Cavanaugh, from the Center for Medicare and Medicaid Innovation, spoke about the Innovation Center’s activity with respect to PCMHs.

Barbara Tobias, medical director at Health Collaborative and Robert and Myfanwy Smith Professor at University of Cincinnati College of Medicine, provided an on-the-ground perspective of PCMHs, given her work with area practices participating in the CMMI Comprehensive Primary Care Initiative.

Dr. Robert Graham, chair of the Alliance board of directors and Melinda Abrams of The Commonwealth Fund moderated the discussion.

The event is sponsored by the nonpartisan Alliance for Health Reform and The Commonwealth Fund.

Event Summary and/or Webcast and Podcast

Full Webcast/Podcast: Full Briefing Video

Speaker Presentations

Robert Graham's Presentation (Adobe Acrobat PDF), 5/3/2013
Melinda Abrams's Presentation (Adobe Acrobat PDF), 5/3/2013
Meredith Rosenthal's Presentation (Adobe Acrobat PDF), 5/3/2013
Barbara Tobias's Presentation (Adobe Acrobat PDF), 5/3/2013

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

Source Materials

Speaker Biographies (Adobe Acrobat PDF), , 5/3/2013
Source List (Adobe Acrobat PDF), , 5/3/2013
Evalutation Form (Adobe Acrobat PDF), , 5/3/2013
Agenda (Adobe Acrobat PDF), , 5/3/2013

Offsite Materials (briefing documents saved on other websites)

Study Demonstrates Value of Practice Supports During PCMH Transition Process, American Academy of Family Physicians, 4/24/2013
How can PCMH impact be inconclusive?, The Advisory Board Company, 3/20/2013
Fact Sheet: Comprehensive Primary Care Initiative. (Adobe Acrobat PDF),Centers for Medicare and Medicaid Services, 8/22/2012
Fact Sheet: Patient-Centered Medical Homes. (Adobe Acrobat PDF),National Committee for Quality Assurance, 1/1/2012
Addressing the Social determinants of health within the Patient-centered Medical home, Journal of the American Medical Association, 4/25/2012
Benefits of Implementing the Primary Care Patient-Centered Medical Home: A Review of Cost & Quality Results, 2012, Patient-Centered Primary Care Collaborative, 12/1/2012
Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers, Journal of the American Medical Association, 6/24/2012
Measuring the Success of Medical Homes: Recommendations from the PCMH Evaluators’ Collaborative, The Commonwealth Fund Blog, 5/18/2012
The Post-Katrina Conversion of Clinics in New Orleans to Medical Homes Shows Change Is Possible, but Hard to Sustain, Health Affairs, 8/6/2012
About Half of the States Are Implementing Patient-Centered Medical Homes for Their Medicaid Populations, Health Affairs, 11/5/2012
Enhancing the Primary Care Team to Provide Redesigned Care: The Roles of Practice Facilitators and Care Managers, Annals of Family Medicine, 1/1/2012
The Changes Involved in Patient-Centered Medical Home Transformation, Primary Care: Clinics in Office Practice, 7/3/2012
Realizing Health Reform’s Potential: How the Affordable Care Act Will Strengthen Primary Care and Benefit Patients, Providers, and Payers, The Commonwealth Fund, 1/4/2012
Medical Homes: Will They Improve Primary Care? (Adobe Acrobat PDF),Mathematica Policy Research, Inc., 6/1/2010
Confonting Costs: Stabilizing U.S. Health Spending While Moving Toward a High Performance Health Care System, Commonwealth Fund Commission on High Performance Health System, 1/10/2012
Survey of 5 European Countries Suggests That More Elements of Patient-Centered Medical Homes Could Improve Primary Care, Health Affairs, 3/1/2013
Quality and Efficiency of Transitioning Small Practices to Patient-Centered Medical Homes, Journal of General Internal Medicine, 3/2/2013
Medical home 2.0 The present, the future (Adobe Acrobat PDF),Deloitte University Press, 5/14/2012
Patient-Centered Medical Home Characteristics and Staff Morale in Safety Net Clinics, Archives of Internal Medicine, 1/9/2012
Early Evaluations of the Medical Home: Building on a Promising Start, American Journal of Managed Care, 2/1/2012
The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction, And Less Burnout For Providers, Health Affairs, 5/1/2010
Reinventing Medicaid: State Innovations To Qualify And Pay For Patient-Centered Medical Homes Show Promising Results, Health Affairs, 7/1/2011
The Patient-Centered Medical Home: A Path Toward Health Equity? (Adobe Acrobat PDF),Discussion Paper, Institute of Medicine, 9/13/2012
What the election outcome means for health care: Initial thoughts, , 12/17/2014




Changing the whole multi-payer environment is essential to the success of medical homes, CMS' Sean Cavanaugh said at a May 3 Alliance briefing, Patient-Centered Medical Homes: Do They Work? CMS is aiming to get findings from pilot projects out to the public, he said. (Photo by James Ryder)


Data is lacking to show that medical homes will save money in insufficiently integrated environments, Meredith Rosenthal of the Harvard School of Public Health said at a May 3 Alliance briefing, Patient-Centered Medical Homes: Do They Work?


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