Impact on Seniors of the Patient-Centered Medical Home: Evidence From a Pilot Study

Abstract

A PCMH redesign can be associated with improvements in patient experience and quality without increasing overall cost.

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

“…Further, we are unable to be certain that every hospitalization that an enrolled subject had during the study period was captured within our available data. Although the potential generalizability of this study may be limited by having been conducted in a single healthcare system, it is important to note that GHC had implemented programmatic interventions to reduce hospitalizations during the 5-year follow-up period, 49,50 suggesting that the magnitude of the association we found between probable major depression and hospitalizations for ACSCs-could be even greater. Finally, the possibility of residual confounding remains as in any observational study.…”

Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use

“…It may be the case, then, that aligning care towards the PCMH model will increase referrals to mental health specialists. 31,32 Several strategies have been recommended for improving the coordination of care between PCPs and MHPs, including co-location of MHPs within primary care settings, the use of depression care managers, and standardized procedures for tracking mental health referrals. Few opportunities exist, however, for healthcare practices to report efforts in implementing these recommended reforms.…”

“…27 Specifically, PCMH qualities of access, comprehensiveness, and patient-centeredness have been associated with improved quality of care for adults with diabetes, better health outcomes for veterans, and lower healthcare expenditures among Medicare beneficiaries. 16,[28][29][30][31][32] In the area of MHS, the benefits of the PCMH model over past approaches to a usual source of care remain unknown. Prior studies that have examined associations between usual sources of care and the use of MHS have often included all types of providers and settings (including the emergency room), without a specific focus on primary care.…”

“…33,34 We hypothesized that patients with a usual provider would be more likely than those with no usual provider to receive any MHS, and that those with a PCMH would be even more likely to receive MHS than those with only a usual provider. Moreover, because the PCMH enhances care coordination and access to medical specialist providers, 31,32 we further hypothesized that patients with a PCMH would be more likely to visit a mental health specialist provider (MHP) than patients with only a usual provider.…”

Teamwork and Delegation in Medical Homes: Primary Care Staff Perspectives in the Veterans Health Administration

“…3 Demonstration projects in a variety of practice settings have evaluated process and outcome-related effects of the PCMH, such as changes in processes of care, 4-6 quality, 7,8 cost, 9,10 utilization, [10][11][12][13] and patient experience. [14][15][16] Recent evaluations of national PCMH initiatives have recommended close examination of primary care staff implementation experiences with an eye towards provider and staff role transformation. 17,18 Role transformation is an integral component of PCMH team function and has emerged as a key topic of inquiry.…”