4 Reasons PCMH Principles Aren't Going Away
A recent analysis finds lackluster results in both cost reduction and quality improvement from organizations that have achieved Patient-Centered Medical Home certification. Does that mean we need to go back to square one?
Have you heard the news? The patient-centered medical home model is a failure.
One takeaway from a recent analysis on the medical home is that for all its purported promise, the designation appears to be little more than window dressing for practices that achieve it.
The report, published in last week's JAMA, and covered well here by my colleague Cheryl Clark, compared quality, utilization, and costs of care delivered to about 120,000 patients in 32 Pennsylvania practices. About half of the patients were treated by physicians in PCMHs certified or recognized by the National Committee for Quality Assurance; the others were treated by physicians in traditional practices.
The conclusion? Physician practices designated as medical homes were no better at controlling costs than traditional practices and were better in only one of 11 quality measures evaluated.
But it would be wrong to dismiss the movement toward patient-centered care as ineffective based solely on the findings of the study.
The report found that compared with traditional practices, NCQA-certified PCMHs did no better at controlling costs than traditional practices. They also did not improve on traditional practices' performance on 10 of 11 quality measures evaluated, such as cholesterol testing and cervical cancer screening, or in avoiding emergency room visits of patients who could have been seen in an ambulatory setting. The only measure where some improvement was seen in the medical home groups was in nephropathy screening for kidney disease in patients with diabetes.
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