With results like that, the pilots are no longer pilots, and all of Affinity's owned practices have adopted the medical home philosophy, and all have received Level 3 designation from NCQA. What was the key to the successful transition from a senior leadership standpoint?
"From senior leadership, you're at the point where you've got to believe in it and you're moving forward," says Loch. "Quit questioning if this is where it's going to go."
Do the patients like it?
Believing in the changes from an executive and clinical point of view is one thing, but the success ultimately rests on whether the patient finds the changes to be an improvement. "We struggle with that because a lot of the work for the patient is done in the background, and it especially comes into play with chronic conditions," says Jane Curran-Meuli, the regional administrator for primary care at Affinity Medical Group. She says that care conferences, behavioral health, and automated outreach through Phytel (a Dallas-based company that provides Affinity a registry that uses evidence-based chronic and preventive care protocols to identify and notify patients due for care) offer multiple opportunities for providers to proactively manage patient care, which improves patient satisfaction and outcomes. "Those who have those conditions certainly see the difference."
Some of the things patients notice include turnaround times for lab results, and how quickly someone at the practice gets back to patients who have called in with a question, says Karla Repta, director of patient care services at Affinity Medical Group.
"The processes have really tightened up those time frames so patient experience is more positive than it was," she says.
Nine out of 10 Affinity patients would recommend the medical home format to their family and friends.
Loch says that measuring the impact on the patient is educated guesswork, and the metrics bear out that patients are generally more satisfied with their care, and costs per patient are going down, so that's good enough for him.
"We evaluate some through our marketing, but we were first out in the market telling people what a medical home is. Everyone's now copying that sell."
Affinity also recently hired a "connection specialist" to make the medical home case directly with employers. "She's talking about how things work, how we connect those with chronic conditions, and she's extolling the virtues of medical home. She's only been here two months, but it seems to be catching on."
One local employer has evaluated all local primary care providers on a 100-point checklist, says Loch, and "they're actually paying the employees and us more to take new patients because they want their employees to come to our clinics."
This article appears in the September 2012 issue of HealthLeaders magazine.