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New Primary Care Model Tested in Demonstration Project

Last Updated: June 08, 2010.

The patient-centered medical home concept, a team-based, integrated approach to patient care, can be implemented currently by motivated primary care practices, but health system and payment reforms are needed to implement it more smoothly, according to a series of reports in a supplement to the May/June issue of the Annals of Family Medicine.

TUESDAY, June 8 (HealthDay News) -- The patient-centered medical home (PCMH) concept, a team-based, integrated approach to patient care, can be implemented currently by motivated primary care practices, but health system and payment reforms are needed to implement it more smoothly, according to a series of reports in a supplement to the May/June issue of the Annals of Family Medicine.

The eight reports evaluate the American Academy of Family Physicians' PCMH National Demonstration Project, begun in 2006, in which 36 primary care practices tested the PCMH model, which impacts access to care, care management, information technology, quality improvement, and other care components. Some practices were self-directed in the process, while others were assisted by facilitators.

Overall, the 26-month project resulted in an increase in PCMH components. For facilitated practices, the average 17 PCMH components at baseline increased by 10.7 components, while for self-directed practices, the average 20.1 components at baseline increased by 7.7 components. Medical record audits documented moderate quality improvements for ambulatory care, preventive care, and chronic disease care. However, patient-rated outcomes were not improved, including access, comprehensive care, coordination, and personal relationship. The PCMH components least likely to be implemented included wellness promotion, e-visits, group visits, population management, and team-based care.

"As the PCMH continues to evolve, both practice and system reforms are needed to make it easier to integrate, personalize, and prioritize care for whole people, communities, and populations," the authors conclude.

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