Advancing Patient-Centered Medical Home Innovation

Advancing
Patient-Centered
Medical Home InnovationMoving from Concept to Practice

What are the major deficiencies in ourcurrent health care delivery system?
Is not patient-centered
Does not allocate adequate resources to support prevention and the improvement of health
Does not clearly define patient and provider responsibilities
Is not based on a foundation of partnerships between patients/providers/payors

Deaths that should not occur in the presence of effective health care
Age-Standardized Death Rates (Per 100,000)
USA
Source: Health Affairs, January 2008

Deaths that should not occur in the presence of effective health care
Age-Standardized Death Rates (Per 100,000)
USA
Since we spend more than anyone else….
Should we expect more value?
USA in last place on this quality measure
Source: Health Affairs, January 2008

“Every system is perfectly designed to achieve the results it gets.”
Donald Berwick, M.D.
Institute for Healthcare Improvement (IHI)

What can be done to address these deficiencies?
Transforming our current delivery system will require advancing patient-centered health care to optimize individual health
A good place to start transformation at a local level is the advancement of patient-centered medical home (PCMH) innovation.

The current primary care system must be transformed to address current issues
Advanced primary care models, like patient-centered medical homes, can provide the coordination mechanisms and decision support to improve quality, cost, and satisfaction
Current challenges confronting primary care
Emergency room visits increased by 36% between 1996 and 2006; 47% of ED visits could have occurred in a physician’s office
20% of patients are readmitted within 30 days of hospitalization, most of which are avoidable
50% of patients that are readmitted do not see a physician after their first hospitalization
75% of health care spending is for patients with chronic diseases
Over two years, the typical Medicare patient sees 2 different primary care doctors and 5 different specialists
Millions of additional Americans will enter the primary care system with health reform

What is a patient-centered medical home?
The patient‐centered medical home is a model for care provided by physician practices that seeks to strengthen the physician‐patient relationship by replacing episodic care based on illnesses and patient complaints with coordinated care and a long‐term healing relationship.
At the core is a physician-directed team committed to coordinating care based on patients’ needs and priorities, communicating directly with patients and their families, and integrating care across settings and practitioners.

What is a patient-centered medical home?

A comparison of then and now…

How will we evaluate improvements?
Evaluation of Patient-Centered Medical Homes focused on:
Improved access to care
- Be immediately accessible for patient concerns
- Promptly treat acute illness
- Create new opportunities to provide preventive care and chronic disease management
Controlling health care costs
- Prevent needless emergency department visits
- Intervene early to reduce hospitalizations
Patient Engagement- Do patients value care coordination? - Do patients value patient-centered approach?

What will be required to sustain the transformation?
Health plan and employer commitment to the transformational change
Need primary care organization commitment to transforming their care delivery model
Need patient engagement in managing/improving their own health care

A summary on measuring financial ROI?

A summary on measuring financial ROI?
Investment in Patient-Centered Medical Home Model has potential for break-even return (or better) in year 1!

Introduction to Patient-Centered Medical Home
Click below to watch a brief 5 minute overview:
http://www.pcpcc.net/content/emmi

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Advancing Patient-Centered Medical Home Innovation

by Access HealthColumbus on Feb 22, 2010

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Advancing Patient-Centered Medical Home Innovation — Presentation Transcript