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PCMH: Shouldn't Patients Have Their Say?

Philip Betbeze, for HealthLeaders Media, April 25, 2014

"I think highly of the people who conducted this study," he says. "They didn't do that study thinking it wasn't going to work."

For that matter, no one undertakes the substantial investment in the tools and human capital necessary to achieve PCMH designation thinking it's not going to work either. But the results speak for themselves. Or do they?

Not the Final Word
Langston cautions that while the study measured the before and after performance of 32 early-adopting practices over a three-year period between Jun 1, 2008 and May 31, 2011, it is not the final word on the effectiveness of the medical home construct, especially as far as patient preferences are concerned.

While the JAMA study's findings show little progress toward the goals of the PCMH, its results don't necessarily reveal the true picture of the benefits the medical home can deliver in both cost and quality spectrums, says Langston. In other words, the jury is still out, in his mind.

"In the methodology, only half the participating practices actually reached Level III [the highest PCMH designation]—only 16–so are we really evaluating the patient-centered medical home?" he asks. "The medical home lays out the walls and ceiling but doesn't decorate the room."

What distinguishes the failures from the successes in primary care, he says, is going to another level of specificity of the elements in the PCMH that are intended to help patients better access the care they need and keep themselves healthier.

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1 comments on "PCMH: Shouldn't Patients Have Their Say?"


Randy Wexler MD MPH FAAFP (4/26/2014 at 11:47 AM)
It is unfortunate that a single study (likely because it was in JAMA)has been received as if it is the quintessential study on what a PCMH can do. That is troubling. In this study physicians were paid to achieve NCQA recognition. Not provide PCMH care. This is a very important distinction. In addition they were tasked with recognition under the 2008 requirements, and it was 2011 when quality improvement was added. The Patient Centered Primary Care Collaborative at http://www.pcpcc.org/resource/medical-homes-impact-cost-quality provides overwhelming evidence as to the benefits of PCMH care. Cost is reduced and outcomes improved in those places providing PCMH care, whether NCQA recognized or not. As such, it is what you deliver, not what you call the delivery of care that is important, and the delivery of PCMH care is the key.