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  • Medical Home Models Continue to Report Positive Outcomes

    Patient-centered medical home (PCMH) initiatives across the US are continuing to report mostly good news, with demonstrated decreases in cost of care, visits to emergency departments (EDs), and inpatient admissions.

    The outcomes were documented in an annual update of evidence (.pdf) produced by the Patient-Centered Primary Care Collaborative, which reviewed 20 studies (13 peer-reviewed, 7 industry-generated) released between August 2012 and December 2013. While report authors describe supporting evidence as in its "early" stages and warn that the update itself is not "a formal peer-reviewed meta-analysis," they write that the evidence "suggests that when fully transformed primary care practices have embraced the PCMH model of care, we find a number of consistent, positive outcomes."

    Among the findings:

    • Reductions in costs were reported in 12 of the 20 studies (8 of the 13 peer-reviewed analyses, and 4 of the 7 industry analyses), with the same numbers reporting decreases in ED visits.
    • Inpatient admissions were reported as decreasing in 4 of the industry analyses and 4 of the peer-reviewed studies.
    • While 4 of the peer-reviewed studies reported improvements in patient access to care, only 1 of the industry analyses reported improvements in this area.
    • Improvements were also cited in readmission rates, overall population health indicators, and preventive services, though less consistently than reported improvements in cost and ED visits.

    Authors of the update wrote that the latest reports bolster the argument that the benefits of the PCMH model tend to accrue over time, and that primary care practices could see significant improvements in outcomes if other policy changes are put in place that shift care away from the fee-for-service model "to one that rewards quality, efficiency, and innovation." The report cited the potential end to the flawed sustainable growth rate (SGR) now being discussed in Congress as a change that could significantly help the move toward new models of care.

    The patient-centered medical home concept has been an area of focus at APTA for some time. APTA has engaged in advocacy to ensure that physical therapists (PTs) have a voice in the development of medical home models, and has supported the development of the Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services. In addition, APTA offers a series of videos on collaborative care models, including a presentation on the PT's role in the medical home.


    • how can physical therapists get involved in this?

      Posted by helene on 1/14/2014 7:03 PM

    • While physical therapists are not expressly named in the Affordable Care Act as part of the medical home model, PTs can contract with medical homes to provide services to their patients and assist in meeting stated quality metrics. This work is done primarily through collaboration with hospitals and primary physician organizations. If you're interested in finding out more, check for patient-centered medical home activities taking place in your state – these could include the Medicare Multi-Payer Advanced Primary Care Demonstration, Medicaid or other state-initiated projects, and/or single or multi-commercial payer demonstration projects or rollouts. The National Academy of State Health Policy has a map of existing medical home models by state for your reference: http://nashp.org/med-home-map.

      Posted by News Now on 1/16/2014 2:42 PM

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