Literature Collection

10041

The Patient-Centered Medical Home

Type: Journal Article

Authors: Susan Henderson, Catherine O. Princell, Sharon D. Martin

Year: 2012

Publication Place: United States

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10042

The Patient-Centered Medical Home and Patient Experience

Type: Journal Article

Authors: Grant R. Martsolf, Jeffrey A. Alexander, Yunfeng Shi, Lawrence P. Casalino, Diane R. Rittenhouse, Dennis P. Scanlon, Stephen M. Shortell

Year: 2012

Publication Place: United Kingdom

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10043

The patient-centered medical home and why it matters to health educators

Type: Journal Article

Authors: Jodi Summers Holtrop, Timothy R. Jordan

Year: 2010

Publication Place: US: Sage Publications

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10044

The patient-centered medical home model: healthcare services utilization and cost for non-elderly adults with mental illness

Type: Journal Article

Authors: J. J. Bowdoin, R. Rodriguez-Monguio, E. Puleo, D. Keller, J. Roche

Year: 2018

Publication Place: England

Abstract: BACKGROUND: The patient-centered medical home (PCMH) model is designed to improve health outcomes while containing the cost of care. However, the evidence is inconclusive. AIMS: The aim of this study was to examine the associations between receipt of care consistent with the PCMH and healthcare services utilization and expenditures for non-elderly adults with mental illness in the USA. METHOD: A surveillance study was conducted using self-reported data for 6908 non-elderly adults with mental illness participating in the 2007-2012 Medical Expenditure Panel Survey. Healthcare services utilization and expenditures were compared for study participants who received care consistent with the PCMH, participants with a non-PCMH usual source of care (USC), and participants without a USC. RESULTS: Differences in utilization and expenditures between participants who received care consistent with the PCMH and participants who had a non-PCMH USC were not statistically significant for any healthcare services category. CONCLUSIONS: Receipt of care consistent with the PCMH was not significantly associated with differences in healthcare services utilization or expenditures compared to having a non-PCMH USC. Research assessing whether the PCMH is cost-effective for non-elderly adults with mental illness is needed.

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10045

The patient-centered medical home neighbor: A primary care physician's view

Type: Journal Article

Authors: C. A. Sinsky

Year: 2011

Publication Place: United States

Abstract: The American College of Physicians' position paper on the patient-centered medical home neighbor (PCMH-N) extends the work of the patient-centered medical home (PCMH) as a means of improving the delivery of health care. Recognizing that the PCMH does not exist in isolation, the PCMH-N concept outlines expectations for comanagement, communication, and care coordination and broadens responsibility for safe, effective, and efficient care beyond primary care to include physicians of all specialties. As such, it is a fitting follow-up to the PCMH and moves further down the road toward improved care for complex patients. Yet, there is more work to be done. Truly transforming the U.S. health care system around personalized medical homes embedded in highly functional medical neighborhoods will require better staffing models; more robust electronic information tools; aligned incentives for quality and efficiency within payment and regulatory policies; and a culture of greater engagement of patients, their families, and communities.

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10046

The patient-centered medical home neighbor: A subspecialty physician's view

Type: Journal Article

Authors: H. F. Yee

Year: 2011

Publication Place: United States

Abstract: To achieve the benefits of the patient-centered medical home (PCMH) model, the American College of Physicians has issued a policy paper addressing the relationship between specialist and subspecialist physicians and PCMH practices. This paper represents a significant step toward improving care coordination and quality by demonstrating that this model is supported by numerous specialties and subspecialties, recognizing the importance of building a strong medical neighborhood, and providing a framework that will foster improvements in care at the interface of PCMHs and PCMH neighbors (PCMH-Ns). Construction of a well-functioning medical neighborhood will, however, require some refinements. First, the proposed interaction typology between PCMHs and PCMH-Ns must be expanded to include innovative forms of interaction that do not depend on traditional office visits, but for which there are clear incentives. Second, the recommended care coordination agreements must be better standardized for the sake of practicality. Finally, genuine dialogue between PCMH and PCMH-N practices needs to be realized.

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10047

The Patient-Centered Medical Home: A Future Standard for American Health Care?

Type: Journal Article

Authors: David B. Klein, Miriam J. Laugesen, Nan Liu

Year: 2013

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10048

The patient-centered medical home: A review of recent research.

Type: Journal Article

Authors: Timothy Hoff, Wendy Weller, Matthew DePuccio

Year: 2012

Publication Place: US

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10049

The Patient-Centered Medical Home: An Ethical Analysis of Principles and Practice

Type: Journal Article

Authors: Clarence H. Braddock III, Lois Snyder, Richard L. Neubauer, Gary S. Fischer, For the American College of Physicians Ethics

Year: 2012

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10050

The Patient-centered Medical Home: An Evaluation of a Single Private Payer Demonstration in New Jersey.

Type: Journal Article

Authors: Rachel M. Werner, Mark Duggan, Katia Duey, Jingsan Zhu, Elizabeth A. Stuart

Year: 2013

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10051

The patient-centered medical home: How to advance patient care through technology

Type: Journal Article

Authors: J. Stape

Year: 2010

Publication Place: United States

Abstract: The process of applying for National Committee for Quality Assurance recognition as a Physician Practice Connections--Patient-Centered Medical Home (PPC-PCMH) can enrich even those practices already solidly committed to providing patient-centric care based on evidence-based medical guidelines. The goal is to leverage information technology to transform both operational and patient care procedures. But even with robust technology, PCMH certification requires team commitment and an unremitting big-picture focus. This article provides an in-depth case study that shows how one groundbreaking Arizona practice used technology to reach the pinnacle of PCMH certification--and continues to use it to improve the quality of patient care.

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10052

The patient-centered medical home: Unprecedented workforce growth potential for professional psychology

Type: Journal Article

Authors: Abbie O. Beacham, Carissa Kinman, Josette G. Harris, Kevin S. Masters

Year: 2012

Publication Place: United States

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10053

The patient-centered medical home: What we need to know more about

Type: Journal Article

Authors: Timothy Hoff

Year: 2010

Publication Place: US: Sage Publications

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10054

The Patient-Centered Medical Home's Impact on Cost & Quality: An Annual Update of the Evidence, 2012-2013

Type: Report

Authors: M. Nielsen, J. N. Olayiwola, P. Grundy, K. Grumback

Year: 2014

Publication Place: Washington, DC

Abstract: This annual report highlights recently published clinical, quality, and financial outcomes of patient-centered medical home (PCMH) initiatives from across the United States. Profiling a showcase of PCMH initiatives, this report focuses on studies released between August 2012 and December 2013 and identifies where they are happening, who is leading them, and highlights the outcomes they are achieving. In addition to the results from these 21 most recent studies, the report includes a summary of PCMH initiatives taking place throughout the US since 2009, which can be found in Appendix A, reflecting 54 different studies organized by state and location. Although the evidence is early from an academic perspective, and this report does not represent a formal peer-reviewed meta-analysis of the literature, the expanding body of research provided here suggests that when fully transformed primary care practices have embraced the PCMH model of care, we find a number of consistent, positive outcomes.A summary of key points from this year's report include: 1.PCMH studies continue to demonstrate impressive improvements across a broad range of categories including: cost, utilization, population health, prevention, access to care, and patient satisfaction, while a gap still exists in reporting impact on clinician satisfaction. 2.The PCMH continues to play a role in strengthening the larger health care system, specifically Accountable Care Organizations and the emerging medical neighborhood model. 3.Significant payment reforms are incorporating the PCMH and its key attributes. The findings are indeed encouraging and the evidence base for the model continues to build at a rapid pace. While we need to be cautious about over-promising what the PCMH alone can deliver, our review of the recent literature affirmatively shows improvements across a number of categories. Our review also suggests some gaps in the evidence and ways to improve future PCMH studies. More robust analyses regarding how PCMH's function, transform and improve outcomes for all patients and their families are critical to the long-term success of primary care, as well as helping the US to achieve much needed, broad-based delivery reform.

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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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10055

The Patient-Centered Medical Home's Impact on Cost and Quality 2013-2014

Type: Report

Authors: M. Nielsen, A. Gibson, L. Buelt, P. Grundy, K. Grumbach

Year: 2015

Topic(s):

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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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10056

The patient-centred medical home in the USA

Type: Journal Article

Authors: T. Epperly

Year: 2011

Publication Place: England

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10057

The patient's voice in the emerging era of participatory medicine

Type: Journal Article

Authors: Dave deBronkart

Year: 2018

Publication Place: United States

Abstract:

Professionalism in any field requires keeping pace with change, and nowhere is it more true than medicine. Knowledge flow has changed dramatically since today's accreditation standards were developed, and change continues more rapidly than ever. It's time for a fresh look at how best to achieve care in this altered environment, where valid knowledge may come from the patient as well as from clinician resources: a sociological change driven by technological change. The power structure of the clinical relationship is inevitably altered as constraints on patient knowledge are loosened by the internet, apps, and devices, undermining a paradigm of patients as uninformed recipients of care based on a one-way flow of wisdom from providers. Case after case is presented showing that patients today have generated undeniable value, violating the expectations and assumed best practices of the old model. To understand this sociological (yet scientific) change, this article reviews the role of paradigms in the history of sciences as described in Thomas Kuhn's landmark book The Structure of Scientific Revolutions and describes how these anomalous patient stories force the conclusion that the traditional paradigm of patients is no longer supportable and a new paradigm is needed. This in turn means our standards of professionalism and appropriate care must be updated, lest we fail to achieve best possible care in our increasingly overburdened system. Our new standard must be to teach clinicians to recognize, welcome, and work with empowered "e-patients" in the new model of participatory medicine.

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10058

The patients' illness perceptions and the use of primary health care

Type: Journal Article

Authors: L. Frostholm, P. Fink, K. S. Christensen, T. Toft, E. Oernboel, F. Olesen, J. Weinman

Year: 2005

Publication Place: United States

Abstract: OBJECTIVE: To investigate if primary care patients' perceptions of a current health problem were associated with use of health care. METHOD: One thousand seven hundred eighty-five patients presenting a new health problem to 1 of 38 physicians from 28 general practices in Aarhus County, Denmark. Patients completed a questionnaire on their illness perceptions and emotional distress before the consultation. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Register data on primary health care utilization 3 years before and 2 years after baseline were obtained. Odds ratios were estimated to examine associations between previous health care use and illness perceptions. Linear regression analysis was performed to examine if illness perceptions predicted later health care use. RESULTS: Previous use: Higher use was associated with psychosocial, stress, and lifestyle attributions. Accident/chance attributions were associated with higher use for patients with a chronic disorder but with lower use for patients without a chronic disorder. A strong illness identity (number of self-reported symptoms), illness worry, a long timeline perspective, a belief that the symptoms would have serious consequences, and all emotional distress variables were associated with higher use. Use during follow-up: Infection/lowered immunity attributions were associated with higher use for patients with a chronic disorder, whereas psychosocial and lifestyle attributions were associated with higher use for all patients. Illness worry and all emotional distress variables predicted higher health care use. A strong illness identity, a long timeline perspective, a belief in serious consequences, and stress and accident/chance attributions were among the strongest predictors of health care use in a multivariate model including all variables. CONCLUSIONS: Patients' perceptions of a current health problem are associated with health care use and may offer an obvious starting point for a biopsychosocial approach in primary care.

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10059

The Pediatric Patient-Centered Medical Home: Innovative models for improving behavioral health

Type: Journal Article

Authors: J. R. Asarnow, D. J. Kolko, J. Miranda, A. E. Kazak

Year: 2017

Publication Place: United States

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10060

The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis

Type: Journal Article

Authors: D. McCarty, T. Rieckmann, R. L. Baker, K. J. McConnell

Year: 2017

Publication Place: United States

Abstract: OBJECTIVE: Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) controls the release of patient information about treatment for substance use disorders. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule to update the regulations, reduce provider burdens, and facilitate information exchange. Oregon's Medicaid program (Oregon Health Plan) altered the financing and structure of medical, dental, and behavioral care to promote greater integration and coordination. A qualitative analysis examined the perceived impact of 42 CFR Part 2 on care coordination and integration. METHODS: Interviews with 76 stakeholders (114 interviews) conducted in 2012-2015 probed the processes of integrating behavioral health into primary care settings in Oregon and assessed issues associated with adherence to 42 CFR Part 2. RESULTS: Respondents expressed concerns that the regulations caused legal confusion, inhibited communication and information sharing, and required updating. Addiction treatment directors noted the challenges of obtaining patient consent to share information with primary care providers. CONCLUSIONS: The confidentiality regulations were perceived as a barrier to care coordination and integration. The Oregon Health Authority, therefore, requested regulatory changes. SAMHSA's proposed revisions permit a general consent to an entire health care team and allow inclusion of substance use disorder information within health information exchanges, but they mandate data segmentation of diagnostic and procedure codes related to substance use disorders and restrict access only to parties with authorized consent, possibly adding barriers to the coordination and integration of addiction treatment with primary care.

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