Advocacy and policy news for internists

Patient Centered Medical Home Comes of Age

The Patient Centered Medical Home (PCMH) clearly is not in the shallow end anymore. The PCMH's team-based patient care model is attracting interest because it places the patient -- and their relationship with a primary care physician -- at the center of care.

The PCMH model calls for a personal physician to provide continuous and coordinated care throughout a patient's lifetime. As envisioned by ACP and other advocates for the PCMH, the PCMH model will be supported by new payment methods to provide higher reimbursements for care provided and coordinated by internists and other primary care physicians. Also, the PCMH will help practices acquire the tools and information systems needed to manage care effectively. Key attributes of a PCMH were described in joint principles developed in 2007 by the ACP, the American Academy of Family Physicians, and the American Osteopathic Association.

The PCMH model of health care delivery has now become a relevant part of the current health reform debate and is being strongly supported by the Patient-Centered Primary Care Collaborative (PCPCC). The PCPCC is a coalition of over 250 employers, consumer advocacy organizations, health plans, and physician advocates (including ACP) that have joined forces to advocate for primary care and the PMCH. The PCPCC has progressed since its first summit meeting a year ago, which focused much of its attention on "What is the PCMH?"

"Now the talk is about how we're going to roll it out," noted Paul Grundy, MD, MPH, chairman of the Patient-Centered Primary Care Collaborative and director of Healthcare Technology and Strategic Initiatives, IBM. "Today, I can respond to doubters with suggestions that they talk to particular individuals about their specific research into the model."

Dr. Grundy spoke last Friday at Healthy Momentum: The Patient-Centered Medical Home Summit, convened by the PCPCC. Nearly 450 health care professionals, administrators and policy makers came to Washington to learn more about the PCPCC effort to implement the PCMH model. Attendees reviewed a report from a PCPCC Work Group on Multi-player Demonstrations, co-chaired by ACP, which describes dozens of projects across the U.S. to roll out and evaluate the impact of the PCMH on quality, cost, and patient and physician satisfaction.

Attendees also learned that the PCMH has strong support among voters. More than 75 percent of the respondents to a Harris Interactive study conducted five weeks ago and released at the Summit said they would increase their support for the next president's health care reform plan if it includes a patient-centered medical home. Advisors from Senators McCain and Obama told the summit attendees that their candidates supported efforts to improve care coordination such as the PMCH.

ACP is an original founding member of the PCPPC and continues to serve on its Executive Committee. Through its leadership in the PCPCC, ACP is able to influence the decisions of the nation's largest employer and consumer advocacy organizations to improve the way general internal medicine and other primary care physician specialties are valued, financed, and reimbursed in the U.S.

October 22, 2008