New Market Research on Medical Homes 2011: One-Third Will Join an Accountable Care Organization
Just five years ago, patient-centered medical homes (PCMH) were a vaguely familiar concept that many healthcare organizations erroneously associated with remote monitoring of patients, in-home care or a physical structure.
Today, the PCMH is a favored model of integrated care delivery and a cornerstone of accountable care — two core elements of healthcare reform. In fact, more than half of the 115 healthcare organizations responding to Healthcare Intelligence Network's fifth annual e-survey conducted in April 2011 said they had established a medical home for their population, and one third said that they will join an accountable care organization (ACO) in the next 12 months.
Responses to the survey revealed insight into the populations that would benefit from this model of care, components of a medical home, PCMH interest in the ACO model and the effects of the PCMH on utilization and cost.
Nearly half of the survey respondents said that Medicare and commercial populations were targeted most often for medical home programs; in 2010, Medicare accounted for more than 60 percent of the target population, with Medicaid and commercial accounting for nearly one half. Pediatrics accounted for more than 40 percent of the target population, a figure that has nearly doubled since 2009.
Similarly to the year before, the majority of 2011 respondents said it took anywhere from 12 to 18 months to convert to a medical home, at a cost ranging from $150,000 to several million dollars. EHRs continued to be an effective health technology tool in the medical home, with e-prescribing also playing a large part in the program. And besides physicians, nurse practitioners and case managers continued to be a large part of the PCMH team. Eighty percent of respondents with case managers on their PCMH care team said that they have a case manager embedded in their physician practice, a figure that has grown by 15 percent in the last year.
When asked what they considered to be the single greatest outcome or benefit of medical homes, respondents cited increased patient and practice satisfaction, improved patient self-managment goals, better coordination of transitional care, and improved HEDIS scores. Respondents also cited improved medication adherence, and a decrease in ER visits.
But there were challenges to PCMHs as well. Increased operating costs was one downside; staff buy-in was another concern. Said one respondent, "There is a great deal of analysis that still needs to be done in order to determine ROI."
Get more details on 2011 Patient-Centered Medical Home Trends.