To establish medical homes, primary care providers must significantly restructure their practices to ensure care is offered in the most convenient and efficient way possible, institute new scheduling procedures, train staff for team-based roles, and engage patients in a new paradigm of care, according to a case study on the Veterans Health Administration's (VA) initiative to build patient-centered medical homes.
In 2010, VA launched a program to create patient-centered medical homes in more than 900 primary care clinics over a 3-year period. In addition to improving chronic disease management, VA's initiative aims to increase access to care, intensify preventive health services, and improve coordination of care as patients move from primary care to specialty care providers and between the VA and private health care systems.
VA modeled its approach on those developed in other integrated health care delivery systems, including Kaiser Permanente, Geisinger Health System, and Duke University Medical Center. The case study details how Patient Aligned Care Teams, knows as PACTs, share responsibility for improving acute care, chronic disease management, health promotion, and disease prevention services. Early results from the implementation of medical homes in Memphis, Tennessee, and Lincoln, Nebraska, suggest that building teams that work collaboratively to improve chronic care management and facilitate patient access can lead to an increased focus on patients' needs. Other benefits include a reduction in the percentage of inappropriate emergency department visits from 52% in June 2010 to 12 % in April 2011 in the Memphis program.
The report is made available by The Commonwealth Fund.
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