Are patient-centered medical homes threatened by cost barriers? Social media conversations
Last week, Diana Manos, Senior Editor at Healthcare IT News, reported on the importance of patient-centered medical homes. She covered the annual National Health IT and Delivery System Transformation Summit, which displayed how PCMH can greatly reduce costs and improve care. One of her sources, James Dearing, DO, a family practice physician, outlined four benefits of a patient-centered home. Here is a recap:
- improved coordination with all players involved in a patient's care;
- improved medication adherence;
- better disease management through the use of registries;
- and improved communication with patients.
A basic search on Twitter for "PCMH" will give you hundreds of reference articles and scholarly journals on how PCMH will directly strengthen a community. Just this past Monday, the Joint Commission Journal on Quality and Patient Safety reported findings that showed the PCMH can increase the percentage of diabetes patients who achieve goals that reduce their sickness and mortality rates.
I think many of us would agree that the advantages of a PCMH outweigh the negatives. However, when asking our Healthcare Finance News social media followers their opinion, the two prime obstacles that came up were costs and communication.
Twitter follower James Ellis, @JamesAEllis, a frequent blogger for Healthcare Finance News and Healthcare IT News, gave his two cents on the situation. "ACO implementation is very costly," he tweeted. "If hospitals can utilize the medical home model without hurting margins then it's promising."
Twitter follower and LinkedIn Group member Rebecca Trocki said that the PCMH has to consider all aspects of the healthcare delivery system. "I think PCORI (Patient Centered Outcomes Institute) and the Patient Centered Primary Care Institute (PCPCC) have the right idea but it needs to involve all the voices and form a consensus including business and government" she wrote on the Healthcare IT News LinkedIn page. "Partnerships should be formed and utilized both public and private. Team based collaboration has to be a key component including the IT and healthcare teams."
The downside of PCMH is the families that fall through the cracks. One of those people is Pam Charney, a nutrition informatics consultant in Seattle and a Healthcare Finance News LinkedIn group member. Pam shared her story with us, explaining that she believes the concept of PCMH is an outstanding idea in theory, yet it doesn't seem to be working well in her community.
Pam is a mother of a child with complicated medical needs. She explained to followers how she unusually learned her Health Maintenance Organization (HMO) had been moved to the PCMH model. "Our HMO never notified us that her care was being moved to the PCMH model," she wrote. "So, how did I find out? The complex condition care coordinator stopped calling me to check in. So, we are in a PCMH, but have had no improvement in care coordination."
This is only one example of the faulty communication that lies within the system.
"On Health Care Technology" blog is an online forum for primary care physicians wanting to express their thoughts to audiences. This week, an anonymous physician posted the blog, "Voices of Primary Care: What is a Medical Home?" in order to voice concern about what the PCMH neglects to offer.
He or she writes:
"We all carry an image of our own HOMES: it is often idealized in phrases such as 'Home-sweet-home' or 'There is no place like home' or 'Home is where the heart is.' We even talk about being 'HomeSick.' Do any of these even remotely resonate with 'THE Medical Home'?"
The MD closes with another question asking readers to thoroughly think about this idea. "Isn't the intention of the medical home movement really an effort to reassert the importance of solid, comprehensive primary care built on the ongoing relationships between the patient and his or her primary care physician?"
These are all justified debates that should be asked by PCMH advisors. Whether it's the devout mother looking for answers, or the faithful doctor trying to better the system, without sitting down and discussing these arising issues, the future of PCMH does not look too promising.
