Everyone, it seems, wants in on the medical home business, but the medical home practice implementation consulting service TransforMED got in on the ground floor.
A subsidiary of the American Academy of Family of Physicians, TransforMED was launched in June 2006 as part of the AAFP’s two-year, 36-practice national demonstration project. Eighteen of the demonstration practices were on their own, and 18 received help from TransforMED—which has since gone on to help guide almost 700 practices in adopting the medical home model. The model calls for coordinated care, a “whole-person orientation,” and increased patient access, which includes providing secure electronic doctor-patient messaging and offering same-day scheduling options.
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Without hesitation, Dr. Allan Korn, the Blue Cross and Blue Shield Association's chief medical officer and senior vice president for clinical affairs, declared that the patient-centered medical home has the potential to transform the U.S. healthcare system.
"The things you want going up are going up, and the things you want going down are going down," said Korn in an interview following his appearance Monday on a panel assessing the state of the healthcare industry presented in San Antonio at the MGMA-ACMPE's annual conference. "There's no question that the medical home is working, and that's what's gratifying to me."
While speaking on the panel, Korn said he thinks steps could be taken to improve the patient-centeredness of the medical-home practice model. Still, he said later, medical homes—which use information technology to coordinate care and track the treatment of patients who have chronic diseases—have led to double-digit declines in patients' exposure to radiation from diagnostic tests, in "ambulatory-sensitive" hospital admissions, and in unnecessary and costly healthcare episodes.
They have also boosted physician satisfaction.
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The 500 medical practices participating in the CMS Comprehensive Primary Care Initiative are going to be under a lot of pressure, as it is now up to them to prove that the patient-centered medical-home model works clinically and economically.
Let's face it: Government-sponsored pilot programs and demonstration projects come and go. Most produce some headlines at their launch, then they generate a few research papers a year or three after their completion, and then they're forgotten.
But hopes are higher for the CPCI, which was described as "very well-conceived, well-designed and, so far, a well-executed program" by Patrick Gordon, program director for the Colorado Beacon Consortium and director of government programs for consortium member Rocky Mountain Health Plans based in Grand Junction, Colo., an area contending for the country's coordinated-care crown.
The key to the four-year effort is that around 60% of the patient bases for participating practices will be covered by plans providing per member, per month management fees. In the case of Medicare, it will be $20, with the fees for Medicaid and other participating private payers yet to be determined.
According to Gordon, it could "fundamentally change the economics of primary care" if the care coordination results in fewer hospitalizations and lower global costs to the country's healthcare bill.
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