Literature Collection

581

Using Team Training to Transform Practice within a Geriatrics‐Focused Patient‐Centered Medical Home

Type: Journal Article

Authors: Elizabeth N. Harlow, Karina I. Bishop, John D. Crowe, Jane F. Potter, Katherine J. Jones

Year: 2019

Publication Place: New York

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582

Using the PACT Resources Framework to Understand the Needs of Geriatric Primary Care Teams

Type: Journal Article

Authors: Samantha L. Solimeo, Melissa J. A. Steffen, Ellen E. Gardner, Omonyêlé Adjognon, Marlena H. Shin, Jennifer Moye, Jennifer L. Sullivan

Year: 2020

Publication Place: Malden, Massachusetts

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583

Utilization and Adherence in Medical Homes: An Assessment of Rural-Urban Differences for People With Severe Mental Illness

Type: Journal Article

Authors: M. Kilany, J. P. Morrissey, M. E. Domino, K. C. Thomas, P. Silberman

Year: 2018

Publication Place: United States

Abstract: BACKGROUND: The complex nature of managing care for people with severe mental illness (SMI), including major depression, bipolar disorder, and schizophrenia, is a challenge for primary care practices, especially in rural areas. The team-based emphasis of medical homes may act as an important facilitator to help reduce observed rural-urban differences in care. OBJECTIVE: The objective of this study was to examine whether enrollment in medical homes improved care in rural versus urban settings for people with SMI. RESEARCH DESIGN: Secondary data analysis of North Carolina Medicaid claims from 2004-2007, using propensity score weights and generalized estimating equations to assess differences between urban, nonmetropolitan urban and rural areas. SUBJECTS: Medicaid-enrolled adults with diagnoses of major depressive disorder, bipolar disorder or schizophrenia. Medicare/Medicaid dual eligibles were excluded. MEASURES: We examined utilization measures of primary care use, specialty mental health use, inpatient hospitalizations, and emergency department use and medication adherence. RESULTS: Rural medical home enrollees generally had higher primary care use and medication adherence than rural nonmedical home enrollees. Rural medical home enrollees had fewer primary care visits than urban medical home enrollees, but both groups were similar on the other outcome measures. These findings varied somewhat by SMI diagnosis. CONCLUSIONS: Findings indicate that enrollment in medical homes among rural Medicaid beneficiaries holds the promise of reducing rural-urban differences in care. Both urban and rural medical homes may benefit from targeted resources to help close the remaining gaps and to improve the success of the medical home model in addressing the health care needs of people with SMI.

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584

Value-based financially sustainable behavioral health components in patient-centered medical homes

Type: Journal Article

Authors: R. G. Kathol, F. DeGruy, B. L. Rollman

Year: 2014

Publication Place: United States

Abstract: Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today's health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value-added integrated behavioral health care in the PCMH. These components are to: (1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioral health care; (3) use proactive onsite behavioral "teams;" (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services.

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585

Varied Rates of Implementation of Patient-Centered Medical Home Features and Residents' Perceptions of Their Importance Based on Practice Experience

Type: Journal Article

Authors: M. P. Eiff, L. A. Green, G. Jones, A. V. Devlaeminck, E. Waller, E. Dexter, M. Marino, P. A. Carney

Year: 2017

Publication Place: United States

Abstract: BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features. Annual resident surveys (n=690) assessed perceptions of importance of PCMH features using a 4-point scale (not at all important to very important). We used generalized estimating equations logistic regression to assess trends and ordinal-response proportional odds regression models to determine if resident ratings of importance were associated with working with those features during training. RESULTS: Implementation of electronic health record (EHR) features increased significantly from 2007-2011, such as email communication with patients (33% to 67%), preventive services registries (23% to 64%), chronic disease registries (63% to 82%), and population-based quality assurance (46% to 79%). Team-based care was the only process of care feature to change significantly (54% to 93%). Residents with any exposure to EHR-based features had higher odds of rating the features more important compared to those with no exposure. We observed consistently lower odds of the resident rating process of care features as more important with any exposure compared to no exposure. CONCLUSIONS: Residencies engaged in educational transformation were more successful in implementing EHR-based PCMH features, and exposure during training appears to positively influence resident ratings of importance, while exposure to process of care features are slower to implement with less influence on importance ratings.

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586

Vermont Blueprint for Health

Type: Web Resource

Authors: Vermont Health Care Reform

Year: 2021

Topic(s):

, , , , ,

Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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587

Veteran family reintegration, primary care needs, and the benefit of the patient-centered medical home model

Type: Journal Article

Authors: R. Hinojosa, M. S. Hinojosa, K. Nelson, D. Nelson

Year: 2010

Publication Place: United States

Abstract: Men and women returning from the wars in Afghanistan and Iraq face a multitude of difficulties while integrating back into civilian life, but the importance of their veteran status is often overlooked in primary care settings. Family physicians have the potential to be the first line of defense to ensure the well-being of veterans and their families because many will turn to nonmilitary and non-Veterans Affairs providers for health care needs. An awareness of the unique challenges faced by this population is critical to providing care. A patient-centered medical home orientation can help the family physician provide veterans and their families the care they need. Specific recommendations for family physicians include screening their patient population; providing timely care; treating the whole family; and integrating care from multiple disciplines and specialties, providing veterans and families with "one-stop shopping" care. An awareness of the unique challenges faced by veterans and their families translates into better overall outcomes for this population.

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588

VHA Patient-Centered Medical Home Associated With Lower Rate of Hospitalizations and Specialty Care Among Veterans With Posttraumatic Stress Disorder

Type: Journal Article

Authors: I. Randall, D. C. Mohr, C. Maynard

Year: 2017

Publication Place: United States

Abstract: OBJECTIVE: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). METHODS: VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012. Outcomes included hospitalizations, primary, specialty and mental health visits, and emergency department and urgent care visits. We utilized negative binomial regression and extended estimating equation models for the full sample. The analysis contained 696,379 unique veterans in both pre- and post-PACT periods. We estimated the linear incremental effect of PACT on utilization outcomes. RESULTS: PACT were associated with a decrease in hospitalizations (incremental effect [IE]: -0.02; 95% confidence interval [CI]: -0.03, -0.01), a decrease in specialty care visits (IE: -0.45; 95% CI: -0.07, -0.23), and an increase in primary care visits (IE: 0.96; 95% CI: 0.67, 1.25). CONCLUSIONS: The period following PACT implementation was associated with a lower rate of hospitalizations and specialty care visits, and a higher rate of primary care visits for veterans with PTSD, indicating enhanced access to primary care.

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589

What "patient-centered" should mean: Confessions of an extremist

Type: Journal Article

Authors: D. Berwick

Year: 2009

Abstract: "Patient-centeredness" is a dimension of health care quality in its own right, not just because of its connection with other desired aims, like safety and effectiveness. Its proper incorporation into new health care designs will involve some radical, unfamiliar, and disruptive shifts in control and power, out of the hands of those who give care and into the hands of those who receive it. Such a consumerist view of the quality of care, itself, has important differences from the more classical, professionally dominated definitions of "quality." New designs, like the so-called medical home, should incorporate that change.

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590

What primary care psychology has to offer the Patient-Centered Medical Home

Type: Journal Article

Authors: Susan H. McDaniel, Colleen T. Fogarty

Year: 2009

Publication Place: United States

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591

What we need to know about behavioral health and psychology in the patient-centered medical home

Type: Journal Article

Authors: Rodger Kessler

Year: 2010

Publication Place: United Kingdom: Wiley-Blackwell Publishing Ltd.

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592

When a usual source of care and usual provider matter: Adult prevention and screening services

Type: Journal Article

Authors: Lynn A. Blewett, Pamela Jo Johnson, Brian Lee, Peter B. Scal

Year: 2008

Publication Place: Germany: Springer

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593

Who is on the home team? Redefining the relationship between primary and specialty care in the patient-centered medical home

Type: Journal Article

Authors: Asaf Bitton

Year: 2011

Publication Place: US: Lippincott Williams & Wilkins

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594

Why do you need to move beyond first-line therapy for major depression?

Type: Journal Article

Authors: L. Culpepper

Year: 2010

Publication Place: United States

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595

Why there must be room for mental health in the medical home

Type: Journal Article

Authors: S. M. Petterson, R. L. Phillips, A. W. Bazemore, M. S. Dodoo, X. Zhang, L. A. Green

Year: 2008

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596

Wisconsin Statewide Medical Home Initiative

Type: Web Resource

Year: 2014

Topic(s):

,

Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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597

Youth Access to Medical Homes and Medical Home Components by Race and Ethnicity

Type: Journal Article

Authors: Bridget E. Weller, Sarah J. Faubert, Anna K. Ault

Year: 2020

Publication Place: , <Blank>

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598

Youths' health-related social problems: concerns often overlooked during the medical visit

Type: Journal Article

Authors: A. Hassan, E. A. Blood, A. Pikcilingis, E. G. Krull, L. McNickles, G. Marmon, S. Wylie, E. R. Woods, E. W. Fleegler

Year: 2013

Publication Place: United States

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