Is PCMH faltering, NYT says YES per article Health Affairs 3-2011

[Guest guest]

RE PCMHs don't really work???? Thus says the data...

Well, I messed up the earlier posting (blame it on this week as my "staycation", the first week "off" in 4 years, and early rising and no coffee) but I ran across this "little" article saying PCMHs are NOT really working....did anyone address this before?

Amazing in this world of "the data has to show it" that we IGNORE the data when it's inconvenient.

I put it on the bulletin board too.

Matt in Western PA

http://prescriptions.blogs.nytimes.com/2011/03/08/a-team-approach-to-patient-care-falters/?emc=eta1

RE PCMH falters.

Anyone have full article referred to here in the NYT article "A Team Approach Falters" by Nutting et al.

http://prescriptions.blogs.nytimes.com/2011/03/08/a-team-approach-to-patient-care-falters/?emc=eta1

A Team Approach to Patient Care Falters

By ANAHAD O'CONNOR

I believe this is very important as more and more monies will be sent to this "garbage" so the "team concept" will be held up as the "only way" to give good quality care. Why noone is willing to see the Meaningful Use measurements as "enough" to justify changing reimbursement is beyond me, but THEN to have the measurements that "it doesn't work" and we'll just keep shoving money at more bloated admin charges just makes me mad.

Here's the abstract from Health Affairs Journal: March 2011; Volume 30, Issue 3

Transforming Physician Practices To Patient-Centered Medical Homes: Lessons From The National Demonstration Project

A. Nutting1,*, F. Crabtree2, L. 3, Kurt C. Stange4, 5 and Jaén6

+ Author Affiliations

1 A. Nutting (paul.nutting@...) is a professor of family medicine and the director of research at the Center for Research Strategies, University of Colorado Health Sciences Center, in Denver.

2 F. Crabtree is the director of research, Department of Family Medicine, at the University of Medicine and Dentistry of New Jersey, in Somerset.

3 L. is chair of the Department of Family Medicine at the Lehigh Valley Health Network, in town, Pennsylvania.

4Kurt C. Stange is a professor of family medicine at Case Western Reserve University, in Cleveland, Ohio.

5 E. is a senior scientist and director of evaluation at the American Academy of Family Physicians National Research Network, in Leawood, Kansas.

6 R. Jaén is chair of the Department of Family and Community Medicine, University of Texas Health Sciences Center, in San .

*Corresponding author

Abstract

Many commentators view the conversion of small, independent primary care practices into patient-centered medical homes as a vital step in creating a better-performing health care system. The country’s first national medical home demonstration, which ran from June 1, 2006, to May 31, 2008, and involved thirty-six practices, showed that this transformation can be lengthy and complex. Among other features, the transformation process requires an internal capability for organizational learning and development; changes in the way primary care clinicians think about themselves and their relationships with patients as well as other clinicians on the care team; and awareness on the part of primary care clinicians that they will need to make long-term commitments to change that may require three to five years of external assistance. Additionally, transforming primary care requires synchronizing practice redesign with development of the health care “neighborhood,” which is made up of a broad range of health and health care resources available to patients. It also requires payment reform that supports practice development and a policy environment that sets reasonable expectations and time frames for the adoption of appropriate innovations.

Matt Levin, MD

matlev@...

FP since 1988

Solo since 2004