Group Health’s Move To The Medical Home: For Doctors, It’s Often A Hard Journey

Meyer, Harris

doi:10.1377/hlthaff.2010.0345

Cited by 15 publications

(19 citation statements)

References 3 publications

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“…However, this time may be useful in coordinating patient care 8,9 and substituting for office visits that would otherwise occur 5,10 , thus potentially reducing costs and saving time for patients and physicians 11,12 . Furthermore, innovative models substituting telephone and electronic communication for visits have found that patients are satisfied with and may prefer this time-saving approach 12,13 .…”

Section: Introductionmentioning

confidence: 99%

Patient Care Outside of Office Visits: A Primary Care Physician Time Study

et al. 2010

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Section: Introductionmentioning

confidence: 99%

Patient Care Outside of Office Visits: A Primary Care Physician Time Study

et al. 2010

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“…Viewing the PCMH as an intrinsically valuable investment has been shown to be critical to motivate practice change (Wise et al, 2011). Moreover, consistent with other studies of medical home transformation, the traditional physician-centric primary care practice and corresponding mental models do not align well with the medical home model (Meyer, 2010;Nutting, Crabtree, & McDaniel, 2012;Nutting et al, 2010). This was particularly true for physicians who needed to rework their view of the traditional physician-patient relationship to reflect a team-based model of care, requiring more open interaction and sharing with other care providers .…”

Section: Discussionmentioning

confidence: 74%

Implementing the patient-centered medical home in complex adaptive systems

Flieger

2017

Health Care Manage Rev

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“…We cannot predict health or experiential changes, which can be more directly assessed through traditional evaluation methods 3,6,[64][65][66][67][68][69][70][71][72] ; hence, we focused on the financial implications of practice-level management decisions, which are often assessed through modeling.…”

Section: Discussionmentioning

confidence: 99%

Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model

Basu

Phillips

Song

et al. 2016

The Annals of Family Medicine

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PURPOSEWe assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. METHODSWe estimated practices' changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. RESULTSUnder the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (-$53,500, 95% CI, -$69,700 to -$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased.CONCLUSIONS PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding. Ann Fam Med 2016;14:404-414. doi: 10.1370/afm.1960 INTRODUCTIONA s of 2014 at least 114 distinct initiatives from state, federal, and private payers funded primary care clinics to offer services as patient-centered medical homes (PCMHs)-practices delivering comprehensive care for most health problems; coordinating care among multiple clinicians; and achieving heightened standards for accessibility, quality, and safety. [1][2][3][4] These initiatives, which now involve at least 21 million patients in the United States, 4 intend to improve access and quality while delivering population-based care at lower cost. [1][2][3] To do so amidst workforce constraints, practices face challenges, including adopting process improvement techniques and electronic registries for care management, expanding care teams, offering patients longer in-person visits and access to electronic or telephone visits, and extending night and/or weekend business hours to enhance care access. 1,[5][6][7][8] According to recent national surveys, 3 major payment strategies have dominated PCMH initiatives: increased fee-for-service (FFS) payments, traditional FFS payments with additional per-member-per-month (PMPM) payments, and Sanjay Basu, MD, PhD 1,2 Russell S. Phillips, MD 2,3 Zirui Song, MD, PhD 2,4 Bru...

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Group Health’s Move To The Medical Home: For Doctors, It’s Often A Hard Journey

Cited by 15 publications

References 3 publications

Patient Care Outside of Office Visits: A Primary Care Physician Time Study

Patient Care Outside of Office Visits: A Primary Care Physician Time Study

Implementing the patient-centered medical home in complex adaptive systems

Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model

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