CHRT Project: Patient Centered Medical Home

Components of Change Toward PCMH

Care Delivery and Financing System

Using existing data gathered by BCBSM from physician groups from across the state, CHRT is developing a picture of the baseline capacities of physician organizations with regard to the desired attributes of a PCMH, investigating barriers and opportunities as physician practices attempt to implement PCMH capabilities; and analyzing PCMH functionality with quality/cost outcomes. Additional funding for this project is provided by the Robert Wood Johnson Foundation.

Goals

This study will investigate the barriers and opportunities that arise as primary care physician practices attempt to implement PCMH capabilities.  More specifically, the project aims to:

• Describe the current status of PCMH topography among participating physician organizations
• Analyze PCMH functionality and organizational/socio-demographic characteristics
• Analyze PCMH functionality and cost and quality outcomes
• Assess the accelerators and/or barriers to implementation of PCMH by physicians

Background

The patient centered medical home (PCMH) is a model of care delivery that includes an ongoing relationship between provider and patient and a comprehensive approach to coordination of care. The American College of Physicians, and the American Academy of Family Physicians have endorsed the medical home as an approach to improve care delivery. While the model has received a great deal of attention as a means to improve health care delivery and quality, little is known about the capacities of physician organizations to become patient centered medical homes. Further studies are needed to better define the core functions of the medical home and their optimal implementation.

Approach

The study has three phases. The first is a descriptive analysis of the topography of PCMH in the participating physician organizations and practices. This includes an analysis of specific PCMH functionality and the organizational characteristics of practices implementing PCMH.

The second phase is an in-depth analysis of the accelerators and/or barriers to change toward the PCMH. The investigators will develop a methodology to classify PCMH capacity as “high” or “low” and then compare and contrast the characteristics of practices in the two groups. This will lead to a better understanding of how to facilitate change toward the PCMH.

The third is analysis of PCMH with cost and quality outcomes.

Related Research and Information

The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care (pdf)
American College of Physicians, Policy Monograph, January 22, 2006.

Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home
Annals of Family Medicine 7:254-260 (2009)

The Need to Test the Patient-Centered Medical Home
JAMA. 2008;300(7):834-835.

Measuring The Medical Home Infrastructure In Large Medical Groups
Health Affairs, 27, no. 5 (2008): 1246-1258