TAFP survey shows challenge
of implementing medical home model

While primary care physician organizations at the state and federal levels push the patient-centered medical home model as a solution to the nation’s health care crisis, the members of those organizations may need more information and support before they can transform their practices into medical homes. That is the conclusion drawn from a recent TAFP survey asking members their opinions on the medical home model.

AAFP, TAFP and many other health care reform groups have identified the medical home as a way to extend the efficiencies of primary care to the entire health care delivery system. The argument is gaining momentum among policy makers and large employers, but many rank-and-file physicians question the viability of the model.

“Doctors need more information about the medical home, about exactly what they have to do to make their practices qualify and how such a change will affect their bottom line,” says Kathy McCarthy, TAFP Chief Operating Officer and Director of Member Services.

More than half of the survey respondents reported that they are somewhat familiar with AAFP’s patient-centered medical home initiative, with 20 percent indicating they were not familiar and 21 percent reporting they were very familiar. Two-thirds said they were interested in becoming a qualified medical home but 74 percent were not familiar with the National Committee on Quality Assurance medical home certification program, which has emerged as the standard certification for medical home pilot projects across the country.

At the close of its two-year demonstration project, TransforMED, AAFP developed the Medical Home IQ Assessment, an online tool designed to show physicians how their practices stack up against the standard medical home model. In TAFP’s survey, 68 percent of respondents said they were not familiar with the tool.

Respondents overwhelmingly listed financial barriers as the chief obstacle to implementing the medical home model.

“We received a flood of comments in the survey, representing a wide range of opinions about the viability of the medical home,” McCarthy says. “There is a lot of skepticism about whether physicians will be able to afford to make the transformation and whether payers will actually pay for the additional services.”

Tom Banning, TAFP CEO, says, “For the patient-centered medical home to be successful, we have to not only persuade government officials, employers and health insurers, but we have to make sure our members have the information and the tools they need.”