Medical Home Monitor
Medical Home Monitor
May 18, 2009
Vol. II, No. 2

Medical Home Monitor Archives

Medical Home Q&A:
Specialist Cost Savings
from the PCMH

Medical Home Monitor

Q: Will the medical home reduce specialist costs and will this result in total dollars being reduced?

A: This is perhaps the most politically charged issue in the PCMH movement right now. Proponents of the PCMH — those who already concluded that this is the ideal way for healthcare to be delivered — would say that there will be less utilization of specialist services because there will be less need for those services. That is, diabetics who are better managed will have fewer complications that require the services of a vascular surgeon, for example. If you dig a little deeper, there will be a sentiment that perhaps better organized and coordinated primary care will result in less need for other specialists’ services. The addendum there is that this is not a replication of the HMO gatekeeper model of the late 1980s and early 1990s — very overtly the PCMH does not call for or relate to a gatekeeper model. It’s essentially a demand-managed model; if better primary care is delivered, they’ll be less need for downstream services. (Don Liss, M.D., regional medical director for the mid-Atlantic region of Aetna.)

For answers to more than 40 questions on the adoption of the PCMH by employers, hospitals and physician practices, please visit:

From Practice to PCMH: Pilot Leaders Vastly Underestimate Magnitude of Medical Home Transformation, Study Finds

While it is possible to transform a primary care practice into a PCMH, those leading other medical home demonstrations around the country vastly underestimate the magnitude, timeframe, technology and capital required to complete the transformation, according to a preliminary evaluation of a two-year national demonstration conducted by the AAFP. The researchers caution that the rush to demonstrate the viability of the PCMH could undermine its effectiveness.

Moving toward the PCMH model is a developmental process that can take up to five years to achieve, the study found, and requires a shift from physician-centered care to a team approach. Rapid transformation can result in staff burnout, turnover and financial distress, the authors noted.

To facilitate the transformation, PCMH pilots should include up-front capital to help purchase health IT, ongoing funding to support personnel changes and support for process change from professional organizations, the NCQA and others.

For more information, please visit:

Medical Home Monitor to Publish Bi-Monthly
Beginning next month, the Medical Home Monitor will publish twice a month to deliver more medical home-focused news, trends, Q&A and white papers — a need identified by our recent readership survey. Have a medical home story idea, question or topic you'd like covered? E-mail the editor at

HealthSounds Podcast: Powering the PCMH with Health IT

A key process change must accompany the adoption of health IT by a physician practice transforming itself into a medical home, notes Dr. James Crawford, senior vice president for laboratory services and chair of the department of pathology and laboratory medicine at North Shore-Long Island Jewish Health System. In this podcast, Dr. Crawford describes the impact of health IT on care coordination and shares the most surprising finding from the PCPCC's survey of physician practices on their use of health IT in support of the medical home model.

To listen to this complimentary HIN podcast, please visit:

Four Physician Groups Issue Guidelines for Medical Home Pilots

The AAFP, AAP, ACP and the AOA — representing nearly 350,000 physicians — have issued 16 recommendations that should be part of any project testing the PCMH model of care. The recommendations cover who should collaborate on the projects; how they should choose practices to participate; what kind of support should be provided to participating practices; how participating practices should be reimbursed; and what each project should to do to analyze and distribute their results.

The guidelines state that any project must ensure that the leaders of local primary care professional organizations have been briefed on the project and given the opportunity to provide input, and that any project should use the NCQA Physician Practice Connections (PPC)-PCMH tool or a similar consensus-based recognition process to qualify practices for participation.

The new document calls for all demonstration projects to reimburse participating practices for the increased physician and administrative staff time necessary to provide care under the PCMH model and calls for projects to broadly and publically disseminate their results after the data have been gathered and analyzed.

For more information, please visit:

HIN Survey of the Month: Healthcare's Response to the Uninsured and Underinsured

So far, more than 70 healthcare organizations have answered this month's e-survey on healthcare's response to the growing numbers of uninsured and underinsured, providing strategies to reduce the financial impact of these populations to ways to make healthcare more accessible and affordable for them. There's still time to share the impact of the uninsured and underinsured on your organization by completing HIN's Survey of the Month. You'll receive a free executive summary of the compiled results, and your responses will be kept strictly confidential.

Complete the survey by visiting:

Medical Homes in 2009: The Healthcare Industry Response

Just published! This new white paper documents the awareness, adoption and impact of the PCMH model of care on more than 220 healthcare organizations that responded to HIN’s Medical Homes in 2009 industry survey.

To download this complimentary white paper, please visit:

Wiring the Medical Home with Health IT: Save $50 when you register by May 22

Wondering how to better position your organization to benefit from some of the billions of promised federal health IT dollars? During Wiring the Medical Home: Healthcare IT to Power a Patient-Centered Model, a 60-minute webinar on May 28, 2009, a physicians’ services organization and a health system will present case studies on the use of health IT in the medical home and its impact on care access, quality and cost. Speakers include Medical Network One CEO Ewa Matuszewski, whose organization requires its physicians to use population-based patient registries to improve care and to prepare for the office and technology transformation required to accommodate the PCMH model; and Dr. James Crawford, senior vice president for laboratory services and chair of the department of pathology and laboratory medicine at North Shore-Long Island Jewish Health System, who co-chairs the PCPCC's Center for eHealth Adoption and Exchange (CeHIA).

Convenient training DVD, On-Demand and CD-ROM formats with printed materials are also available.

Register today with this specially priced admission by visiting:

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Contact HIN:
Editor: Patricia Donovan,;
Sales & Marketing Coordinator: Deirdre McGuinness,;
Publisher: Melanie Matthews,;

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