While evidence regarding the effects of PCMH
on cost, utilization, and quality of care based on demonstration projects is mounting in the United States, (7-9) less is known about their influence on physician labor supply.
The bonuses from the Center for Medicare & Medicaid Services' Meaningful Use and Physician Quality Reporting System "enabled us to develop and support the financial structure required to create the PCMH
," he noted.
This article provides a case study that demonstrates how an elderly urology patient with multiple chronic co-morbidities can be managed through an innovative care model that combines TCM and PCMH
. This same case study also describse how a root cause analysis (RCA) can be an effective strategy to improve outcomes in a homebound older adult male with urinary retention.
I agree with the authors that staffing in the ambulatory care setting should be related to population problems and complexity; however, this is not the case in many situations and nurses in many PCMH
models are feeling the effects of it.
One of the key features of the PCMH
initiative is providing continuity of care through a system where each patient is regularly followed up by a single primary care physician.
If you are already using a PCMH
model, how efficient have you been in using the additional support staff that it requires?
The operations of many new outpatient clinics are designed to support the Patient-Centered Medical Home (PCMH
) model, a concept that was codified by four major physician associations in the "Joint Principles of the Patient-Centered Medical Home" white paper in 2007.
In primary care, the new vehicle for care teams is the Patient Centered Medical Home (PCMH
; Kellerman & Kirk, 2007), which is designed to serve 85%-90% of patients' needs with the broadest "basket of services" possible.
) is an approach to providing comprehensive primary care to patients at all stages of life.
Goals of the Patient Centered Medical Home Model (PCMH
) include delivering primary care in a low cost manner, utilizing care coordination, ensuring high value and improving health outcomes The "Triple Aim" is Improved Patient Experience, Improved Population Health, and Lower Cost" (IHI 2013).
Currently, you may be juggling requirements for the Physician Quality Reporting System (PQRS), patient-centered medical home (PCMH
), and accountable care organization (ACO) while preparing your practice for the transition to ICD-10, but there are additional pieces on the horizon--such as the White House precision medicine initiative, Meaningful Use (MU) Stage 3, changes to Medicare patient volume, and yet-to-be-decided interoperability demands.
Building on the work of a large and growing community, the Agency for Healthcare Research and Quality (AHRQ) defines a medical home not simply as a place but as a model of the organization of primary care that delivers the core functions of primary health care" (PCMH