The Doctors Next Door

Want to Cut Healthcare Costs & Improve Outcomes?

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Sounds like a fantasy, doesn't it? Well, here's a concept that could make it a reality - it's called the Patient Centered Medical Home (PCMH). There's an article in yesterday's Trib about it.

To put it simply, the PCMH is a medical home built on a strong foundation of primary care that is a comprehensive, team-based, coordinated, and cost-effective approach to improving healthcare. And it works.

But let's talk money first. We know that the US spends more per capita on healthcare than any other country and our outcomes are horrible. We're certainly not getting our money's worth. But consider this...

The North Carolina Medicaid system implemented many of the concepts of the PCMH over several years. It paid off. During 2006, they saved $124 million dollars. In just one year.

Erie County in New York started a similar program. They saved $1 million dollars for every 1000 patients. Impressive and there's more.

The VA integrated some components of the PCHM such as information technology with a primary care emphasis. It costs them $6,000 less per year for a veteran over 65 years than for a Medicare patient. That's quite a savings.

Why is the PCMH more cost-effective? It saves money because the basis of a PCMH is primary care. Research studies and systems in other countries show that regular preventive and primary care provide better healthcare outcomes while reducing the per person cost, decreasing expensive emergency room visits and hospitalizations, and minimizing unnecessary tests and procedures. As an added bonus, patient satisfaction is improved.

It just coincidentally happens to be National Primary Care Week and tomorrow, the Patient-Centered Primary Care Collaborative Third Annual Summit will meet to discuss the role of the PCMH in healthcare reform.

In addition to those attending the Summit and those on the Hill, insurance companies are also seeing the value of the PCMH. The largest insurer in our state, Blue Cross and Blue Shield of Illinois, just announced they would enroll approximately 20,000 patients in pilot programs in Elmhurst and Blue Island.

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They're not the only ones building a PCMH. We're "remodeling" our clinic to incorporate the seven key characteristics of a PCMH:

1. Personal physician

2. Physician directed medical practice, meaning a team-based approach led by the doctor

3. Whole person orientation, defined as caring for all stages of a patient's life, including the acute, chronic and preventive needs

4. Coordinated and/or integrated care which is making sure that patients get the care when and where they need it

5. Quality and safety, which translates into better outcomes

6. Enhanced access to care through new scheduling models or alternative ways of communicating with your doctor, such as through email

7. Payment, which means reimbursing for disease prevention, care management, and eliminating the disincentives for primary care doctors

 

Watch for more about the Patient Centered Medical Home here this week.  

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