In Maine, Allen explains, the Maine Health Management Coalition is working with the Maine Quality Forum Advisory Council, the insurance companies, the providers, and the local business to encourage payers to change how physicians are reimbursed to allow the medical home to continue.
“This is a proactive state and we tend to work together. But we need to find a different reimbursement structure in the next couple of years. If we don’t [change] it will put this [program] at risk,” he says.
Though they have no way of knowing what will become of the financial side of this pilot, Penobscot continues to cultivate their program. After adding staff, the next task they undertook, not unlike Southern Maine Medical Center PrimeCare Physicians, was to improve access and get to same-day service of the patient.
When the Penobscot team started, patients sometimes had to wait nearly three months for a follow-up appointment to see their primary care physician. To address the problem, the first step was to open up access. Penobscot did this by expanding office hours to meet the demand, explains Hilary Worcester, a practice manager at Penobscot. They added some weekend hours and extended care until 8 p.m. in the clinic.
“Now when a patient comes in the same day, they are surprised they get to see their own doctor,” she says. “But it adds to the continuity of their care if the patient gets to see the primary care physicians.”
While correcting the access issue was done in short order, one part of the medical home pilot directive that the team continues to struggle with is the creation of a patient advisory committee. “Finding patients who want to meet every other month to talk about things in our practice and what you can do better for them has been a real challenge,” says Worchester. And it’s an area Penobscot continues to try to address.