Building a Successful Medical Home

The clinic also emphasized use of both e mail and telephone encounters—as an alternative or complement to in person visits. This resulted in a 94% increase in e mail use, a 12% rise in more phone consultations—and 6% fewer in person visits.

For the patient experience, those in the pilot reported higher ratings than controls on six out of seven patient experience scales. For staff burnout, 10% of pilot's staff reported high emotional exhaustion at 12 months—compared with 30% of controls, despite similar rates at baseline.

So can this model work around the country? Reid noted that GHC is different than many organizations—for instance, its physicians are salaried. However, to make a model successful, it became apparent that the organization needed money up front to give its providers "breathing" room—time to meet with patients and generally open up time in their day.

"I think it's important to realize that there has to be investment up front," Reid said. But the payout—in terms of less hospitalizations and emergency visits—and even happier patients and providers—may work out in the end.