The Momentum Continues

Patient-Centered Medical Homes are Expanding in Geography and Numbers

Although the concept and basic principles of the medical home were introduced as far back as 1967 by the American Academy of Pediatrics, the current delivery system innovation represented by the Patient-Centered Medical Home (PCMH) is of more recent vintage. And while this model of team-based, coordinated care has many advocates, no one has served as more of a singular champion for the PCMH than Paul Grundy, MD.

As IBM’s Global Director of Healthcare Transformation and the president of the Patient-Centered Primary Care Collaborative, Dr. Grundy has spent much of the past decade working with an international network of thought leaders, industry experts and medical practitioners. In the process he has helped spread new perspectives and develop effective strategies for achieving better, more sustainable health and social outcomes at lower costs – with primary care at the vanguard.  The PCMH has been an essential part of these efforts.

In a recent post on his LinkedIn page, Dr. Grundy noted that the integration of the PCMH into the fabric of health reform continues moving toward a tipping point. Along with its importance as a major component of Accountable Care Organizations, Dr. Grundy added that more and more stakeholders are encouraging the development of PCMH care delivery through programs in which payers, health systems and even employers offer financial incentives to medical practices that gain PCMH designation.

Outside the U.S. Dr. Grundy references similar growth and expansion citing a Canadian example in which demonstration projects in Ontario were so successful that the PCMH model is now being rolled out nationwide. “The first evidence is in,” he writes, “and what we’re seeing is the potential – and the reality – of a system where we pay less for comprehensive, integrated care in which primary medicine, formatted as a PCMH, takes on more responsibility for raising the quality of care, increasing access and providing preventive services.”

As primary care practitioners, our ability to advance the PCMH model will require a strong foundation to assure effective implementation. My experience within my own family medicine practice as well as my work as a consultant and trainer has strengthened my sense that the solid foundation needed will rely on changes in the exam room. The most important of these changes is a closely coordinated, team care approach that, among its other benefits, enables physicians to focus on patients instead of data entry.

I believe these changes are critical, and I share Paul Grundy’s assertion that the PCMH is too important to our future as primary care physicians, to the future health of our patients and to our collective future as a nation not to give it every opportunity to thrive.