Family Medicine and the Patient Centered Medical Home

One of the most important components in achieving family medicine’s goals of true health care - and payment - reform is the patient centered medical home (PCMH).  The PCMH is much more than a movement by the primary care community to improve health care for our patients.  

In many ways, family medicine practices are already the medical home for their patients.  Whether it’s a private practice, community health center or a residency program, family physicians, by definition and the scope of care they provide, are the best home for patients.

Family medicine is advocating for our country – public and private insurance providers - to adopt the PCMH model.  Government programs (Medicare, Medicaid, Veterans Health, TriCare, Federal employees’ health plan) and private insurance companies should structure their payment to primary care providers based on the medical home model.  

Since October 2007, “Patient Centered Medical Home” has been our mantra in the health care debate to corral participation of legislators, providers, businesses and health plans.  Our goal was to position primary care as a priority solution to the true health care transformation that our nation needs. Now PCMH is more than a concept or a phrase: it has concrete definitions, standards and an application/certification process.    

What is a PCMH in today’s practice environment?  

From AAFP http://www.aafp.org/online/en/home/membership/initiatives/pcmh.html

A patient-centered medical home (PCMH) is simply a better way--a more effective and efficient model of health care delivery. This new model produces better care and lower costs. In a patient-centered medical home:  

Patients have a relationship with a personal physician.

• A practice-based care team takes collective responsibility for the patient's ongoing care.

• Care team is responsible for providing and arranging all the patient's health care needs.

• Patients can expect care that is coordinated across care settings and disciplines.

• Quality is measured and improved as part of daily work flow.

• Patients experience enhanced access and communication.

• Practice uses EHRs, registries, and other clinical support systems.

 For patients: a patient centered medical home…  

…makes sure you get the best possible care with a physician who knows you.
…strives to keep you healthy in order to avoid emergency room visits and hospitalizations.
…provides the best quality care while responsibly containing health care costs.
…creates savings in health care that will keep our economy healthy.
…encourages your involvement in the decision making  

Working toward a medical home in Illinois  

Illinois Medicaid patients are already seeing the benefits of having a “medical home” through the Illinois Health Connect Program.  Over 5,000 primary care practices are designated primary care providers to over 1.8 million Medicaid patients. Although these practices are not nationally certified “medical homes,” they function as Medicaid patients’ usual source of care and first point of contact.  As a result, participating physicians are seeing increased payments and better outcomes for coordinating care.  

The disease management component, Your Healthcare Plus, is working to improve outcomes for some of Medicaid’s most complex patients. All Illinois physicians can benefit from the clinical knowledge and the quality improvement tools available from the Your Healthcare Plus CME program, created by IAFP’s education network.   

Both Illinois Health Connect and Your Healthcare Plus are led by family physicians and shaped by constant feedback from IAFP leaders and family physicians.

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