The Medical Group Management Association says its survey shows that most practices want to become patient-centered medical homes, and finds challenges.
Nearly 70% of 341 physician leaders who replied to MGMA’s Patient Centered Medical Home Study: 2011 Report based on 2011 Data said were already in the process of transforming or interested in becoming a PCMH while more than 20% were accredited or recognized as a PCMH by a national organization.
The nationwide survey, conducted in April for Englewood, CO-based MGMA, found the 36% of practices interested in becoming a PCMH were in family medicine, followed by multispecialty practices with primary and specialty care (more than 30%), and pediatrics (more than 10%).
The study found that the top five most common processes practices engaged in as part of the PCMH model were:
- Assigning patients to a primary care clinician (80%)
- Addressing patients' mental health issues or concerns and referring them to appropriate agencies (70%)
- Exchanging clinical information electronically with pharmacies (70%)
- Involving patients and family members in shared decision making (70%)
- Maintaining chronic disease registries (45%)
The study also indentified the top five challenges cited by PCMHs during their transformation:
- Establishing care coordination agreements with referral physicians (50%)
- Financing the transformation to PCMH (40%)
- Coordinating care for high-risk patients (40%)
- Modifying or adopting an EHR system to support PCMH related functions (40%)
- Projecting financial effects (practice revenue, costs, etc.) of the transformation to PCMH (35%)
For existing PCMHs, 91% of study respondents said that they want one set of standards for PCMH evaluation. The majority of existing PCMHs were recognized through the National Committee for Quality Assurance; 70% of these reported earning Level 3 NCQA recognition. The accreditation or recognition process took the majority of respondents, on average, one year to complete.
Physician-owned practices represented less than 55% of accredited or recognized PCMHs compared to less than 25% for hospital-owned medical practices. Almost 45% of the respondents accredited or recognized as a PCMH were family medicine practices followed by multispecialty practices with primary and specialty care (almost 35%).
The survey also showed that as many as 75% of existing PCMHs reported they were participating in a pilot or demonstration. Ninety percent of pilot participants also were receiving fee-for-service payments from payers as part of the pilots and only 57% indicated receiving management fees.
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John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.