A fundamental shift and support system is proven to be critical as organizations look to align payment incentives and reform care delivery.

As organizations shift from the reactive, visit-based care, many questions have come up around the implementation of the PCMH model. In particular, much discussion has occurred around the related provider payment reform changes.

Care Team Support is Key to Enhancing Care Coordination

We know it is vital for the patient-centered medical home to be able to lean on its care teams for execution. High functioning care must focus on having the patient truly be a contributing member of that care team.

The PCMH needs to be the "foundation" for effective, relationship-based care management. Care management needs to be provided by on-site, PCMH employed clinical providers/care team members.

These are the real patient advocates. 

Research has also supported that patients actually do have higher satisfaction at a primary care practice which has adopted the PCMH model along with lean process changes and payment reform.

Digging Deeper: The PCMH and ACO 

A recent Journal of General Internal Medicine published an article on the topic at large, examining how the PCMH model should evolve in order to keep pace with health care payment reforms. In particular, it examined the "shared savings" approach used by many accountable care organizations.

The article, published online this month, included a suggestion to promote integration of PCMHs and ACOs that read as follows:

ACOs could invest in PCMHs by hiring more primary care providers, expanding office hours, developing information technology and care coordination infrastructure, supporting coaching and learning collaboratives, and dedicating resources to urgent care.

EngageHealth IQ provides the platform, the workflow design implications, and the model of care support for the ACO, PCMH and primary care embedded nurse care manager to do just that—with a focus on customized implementation.

Across a variety of settings, EngageHealth IQ supports medical homes to best improve how care is delivered and how providers are paid.

Although there may be alignment between many of the underlying purposes of the PCMH and ACOs, the article's authors made assertions around the idea of physician payment in each model of delivery system reform. Saying that the PCMH "can serve as a lynchpin of ACOs," the authors concluded what many already believe: that ACOs would need to support the PCMH model within their organizations.

To read the article in its entirety, visit here.

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