4 Reasons PCMH Principles Aren't Going Away

Philip Betbeze, for HealthLeaders Media , March 7, 2014

The Patient-Centered Primary Care Collaborative report says WellPoint predicts its PCMH program could reduce its projected medical costs in 2015 by up to 20% based on analysis of its current medical home projects. So it's investing heavily. So is United Healthcare, which predicts that its PCMH efforts will save twice as much as they cost.

So that leaves us to determine the impact of the recent report. Clearly, it does not show positive results during the time period it measures. It also shows that achieving a certification or designation does not guarantee your investment in the tools of the PCMH will pay off. But does that mean all the time and effort setting up patient-centered medical homes, which payers are increasingly incentivizing, is wasted?

Certainly not. What it will deliver for healthcare is still to be determined, but I'm willing to give the benefit of the doubt to any scheme that will incentivize physician practices and other healthcare organizations to effectively work together to drive value and good outcomes.

Many healthcare organizations that never used to work together on these things are now doing so. It's a huge step forward for an insular, silo-based industry that has really never had to take business risk on how well it does what it's supposed to do—help people get better.

If the option is ditching it in favor of returning to the fee-for-service patient volume game, you can count me out.

Philip Betbeze is senior leadership editor with HealthLeaders Media.
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2 comments on "4 Reasons PCMH Principles Aren't Going Away"

Arun K. Potdar (3/9/2014 at 4:02 PM)
The analysis of the analysis is excellent and it corrosponds with my own life experiences working in the Medical Practice Management areas. However there is another angle that needs to be discussed which is touched briefly in this report. That is the area of Pardigm Shift happening in the health care provider industry. I found lot of resistance from the clinicians whenever a new approach to practice management was discussed. Similarly, allied trades supporting the practice management like PA and Practice managers are not prepared for facing the PCMH during their training phases. Clinicians also do not see a buy-in values in operating in these environments and as you mentioned, ' taking responsibility of a patient beyond the practice premises is still not accepted as a duty but looked upon as added burden because of lack of incentives that can be seen immediately as one sees in a FFS arrangement. If this Paradigm shift has to succeed then the seeds must be sowed in the key operator's training areas at their schools and that includes Medical and other clinically allied educational institutes. Existing practices have a major attitude problem where getting a 'Certificate' is drilled in the psyche of the management as a goal that ends with a wall hanging of said certificate. This is the hard part of conversion of mindsets because clinicians themselves do not have a full buy -in of PCMH principles. Thanks for the meaningful insight.

Jeff Angel (3/7/2014 at 2:10 PM)
Phillip, I'm glad we specialists don't practice medicine the way consultants and most insurance-paid think-tanks and masters of public health officials take these studies that dispute your efforts!!Its a disgrace to the medical profession to discount the data!!!Common sense? and you demonize specialists every day, when we practice gold standard medicine? Its sickening to be on my side of your game, yes game. Profiteers and carpetbaggers(consultants, attorneys, managers) want a piece of a small pie[INVALID]-thats what is driving this. Medical inflation is very low over past few years my man.[INVALID]-demographics of population, pure and simple is problem. We have to ration care. Medical homes by primary care docs who don't have the depth of knowledge to properly [INVALID] screenings even for simple musculoskeletal problems or Ob, or gi, etc, etc. is a non-winner except for taking care of chronic conditions. WAKE UP, you are wrong, and now wanting to cry that data proves it!! A sore throat doesn't need a team!!!!!!And a fractured femur or torn cuff doesn't need months of therapy!!!!! The most efficient care is precise diagnosis, with precise speciacilized care when needed. It costs a lot. Rationing end of life care and tiered treatments based on ones production in society is answer. LOL, your article is repulsive from a scientist and doctor who has spent 30 years practicing on data!!!!!!!!!!!!!!!!!!!!!!




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