Patient Centered Medical Homes: Are You Just Checking the Boxes?

April 29, 2016 Brigid Byrne

Ready or not, patient centered medical homes (PCMHs) are here to stay.

Today’s healthcare industry is in the midst of a transformation – one that requires healthcare payment and delivery systems to shift from volume-based to value-based care. This movement places great emphasis on the need to transition primary care practices to alternative payment models like PCMHs. However, this can be a challenging and complex process. Transitioning to a PCMH is a continuous journey that evolves as patient needs change and require new ways of thinking about the delivery of primary care.

What’s so great about PCMHs?

Primary care practices that commit to the PCMH journey and achieve PCMH status have more potential to further population health management success. For example, some of the benefits of the PCMH model include:

  • More timely hospital discharge follow-up and reduced readmissions.
  • Improved patient satisfaction.
  • More efficient preventive care services through the use of disease registries.
  • Reduced unnecessary emergency department (ED) visits.

However, similarly to when hospitals would prepare for an accreditation visit once every three years and then revert back to business as usual, not every primary care practice claiming to be a certified PCMH has actually achieved practice transformation.

Have you successfully transitioned to a PCMH? Try this short quiz:

1) How long does it take a patient to see a primary care provider (PCP) after a hospital discharge?

a. Four to six weeks

b. One to three weeks

c. Less than one week

2)  How much time do PCPs spend tracking down lab results every day?

a.  Two hours

b.  Less than one hour

c. None; lab results are ready for providers when they need them

3)  How often do abnormal lab results or diagnostic reports “fall through the cracks?”

a. Often

b. Sometimes

c. Rarely to never

4)  What is the overall patient satisfaction percentage in primary care practices?

a.  Less than 75 percent

b.  76-90 percent

c.  91-100 percent

How did you do?

If you consider your practice to be a PCMH, but selected any response other than “C,” most likely you are simply just “checking” the boxes.

The nationally accepted joint principles of the PCMH are:

  • Ongoing relationship with a personal physician
  • Physician-directed medical practice
  • Whole person orientation
  • Coordinated and integrated care
  • Safe, quality services
  • Enhanced patient access
  • Payment for added value

While other entities may establish PCMH guidelines based on these principles, the most commonly accepted benchmark for PCMHs is the National Committee on Quality Assurance (NCQA) Standards and Guidelines.

For an assessment of your PCMHs, contact Premier’s PCMH subject matter experts: Carla Dunn or Brigid Byrne. They will provide insight to whether a practice(s) has been fully transformed or are just simply checking the boxes.

Author information

Brigid Byrne

Brigid Byrne

Director, population health at Premier, Inc.

I’m a multi-dimensional person with a background as a nurse practitioner and gerontologist from Texas. I volunteer in a community based, grass roots uninsured clinic focused on broad patient health needs, spiritual and cultural values. When I’m not working you’ll find me playing soccer or being manipulated with chocolate. Connect with me on LinkedIn.


The post Patient Centered Medical Homes: Are You Just Checking the Boxes? appeared first on Action For Better Healthcare.

Previous Article
Baby Boomers, Tattoos and Celebrity Sufferers: The Struggle with Hepatitis C
Baby Boomers, Tattoos and Celebrity Sufferers: The Struggle with Hepatitis C

Did you know that Hepatitis C (HCV) is the leading cause of liver transplants in the U.S., with an estimate...

Next Article
C. Difficile – The Challenge Continues
C. Difficile – The Challenge Continues

Q: What illness: Affects half a million U.S. patients per year? Kills approximately 29,000 patients within ...


Want help with your population health strategy? Meet with an expert.

First Name
Last Name
Phone Number
Thank you! We will be in touch soon.
Error - something went wrong!