Large or small, new tools help transform practices into patient-centered medical homes

posted 05.19.10

Small and solo physician practices are able to successfully incorporate the tenets of the patient-centered medical home just as well as large group practices, if not more. That’s what Terry McGeeney, M.D., M.B.A., CEO of TransforMED, said in a May 12 AAFP News Now guest editorial. He used the editorial to launch a new program designed specifically for small practices with up to four providers, and a briefing paper on successful pilot projects in large practices.

“Like the big guys, small practices in our pilot programs are improving the quality of chronic disease care, reducing ER visits and hospital admissions, and cutting the total cost of care for patients in their pilot populations,” McGeeney wrote. “In addition, our experience has shown that small, independent practices are nimbler and have an easier time changing into PCMHs, compared with larger practices in integrated systems.”

“The PCMH Transformation: A Solution for Small Practices” bundles the components small practices need to become patient-centered medical homes: an initial practice assessment conducted online and over the phone, a comprehensive transformation plan, and help along the way from a dedicated facilitator.

Also, small practices who join the program do not go through the two-year process alone. They are matched into a cohort of other small practices with whom they can share their experiences; given unlimited access to Delta Exchange, TransforMED’s online learning community; and given free admission to the TransforMED Institute, a two-day conference designed to accelerate adoption of the patient-centered medical home. The cost to join the program is $1,250 per quarter for virtual online support or $2,500 per quarter for the on-site option. Practices must commit to a two-year program enrollment. For more information on the small practice package, go to TransforMED’s website, www.transformed.com.

Large practices should not feel excluded. The new briefing paper, “The Outcomes of Implementing Patient-Centered Medical Home Interventions: A Review of the Evidence on Quality, Access and Costs from Recent Prospective Evaluation Studies, August 2009,” outlines eight successful pilot projects from around the country, mostly rooted in large, integrated-delivery systems.

The profiled pilots are:

• Group Health Cooperative of Puget Sound, a consumer-owned integrated delivery system in the Seattle area;
• Community Care of North Carolina, the operator of the North Carolina Medicaid and SCHIP programs;
• HealthPartners Medical Group BestCare PCMH Model, a large consumer-governed organization in Minnesota;
• Geisinger Health System ProvenHealth Navigator PCMH Model, a large integrated delivery system in Pennsylvania;
• Genesee Health Plan HealthWorks PCMH Model, a health plan based in Flint, Mich.;
• Colorado Medicaid and SCHIP, run by the Colorado Department of Health Care Policy and Financing;
• Intermountain Healthcare Medical Group Care Management Plus PCMH Model, part of an integrated delivery system in Utah; and
• Johns Hopkins Guided Care PCMH Model, developed by the university’s School of Public Health.

The authors found that across the different settings and patient populations, the investment to redesign the delivery of care around a primary care patient-centered medial home yielded a favorable return on investment; better quality of care, patient experiences, care coordination, and access; and savings in total costs from reductions in emergency department visits and inpatient hospitalizations.

Read the full six-page document here. Visit the Patient-Centered Primary Care Collaborative at www.pcpcc.net.