Second, PrimeCare Physicians opened a weekend clinic to help meet the patient demand and to reduce ER utilization. Moreover, the practice began scheduling more preventative care visits and the organization increased areas such as mammography to nearly 80% and the colorectal screenings to nearly 60%.
"As a pilot we are working to prove that this does pay off. So when we talk about reduced utilization in the ER and reduced readmission, we know that's where we need to be, but we're still tracking this piece," says Lyons. "We are also following our chronically ill patients and seeing that they come in for all the required tests and following up to see that they do it."
Though data on reduced ER use is not yet available, Sue Butts-Dion, director and quality improvement specialist for the Maine Patient-Centered Medical Home Pilot says early data shows that some of the access work the pilot programs are doing across the state are resulting in decreased ER use. In the next few years the plan is to have more definitive metrics on this.
As the practice has gone through this process, there have been several lessons learned—the care management area was just one of them. "It didn't work for us the way we tried it at first, so we changed it," explains Lyons. "Now our challenge is trying to sustain momentum and not take on more than we can handle."
As SMMC PrimeCare Physicians continues the patient-centered medical home pilot project, some funds are coming in from the effort. Along with seeing an uptick in the number of preventative care procedures and being able to schedule more patients, and in a timely manner, payers are also pitching in.