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Results of first national demonstration project to implement patient-centered medical home released
Date:6/15/2010

decade as they continue transformation to a PCMH and adapt to rapidly changing demands of the health care environment.

Importantly, the authors point out that the NDP practices were not a representative sample of U.S. practices. They were highly motivated early adopters who are continuing to work to implement positive changes, even after two years. For most practices, the pace and magnitude of change experienced by the project participants would not be easily replicated.

Jan cautions that any interpretation of NDP findings must bear in mind what the change strategy did not include interventions to alter the delivery system beyond individual practices. None of the practices saw a change in their payment structure or enhanced reimbursement. "Without fundamental transformation of the health care landscape that promotes coordination, close ties to community resources, payment reform, and other support for the PCMH, practices going it alone will face a daunting uphill climb," he writes.

"There must be simultaneous changes in an integrated model in what has been referred to as an optimal healing landscape," concludes Crabtree. "The NDP findings must be interpreted in the context of what is being learned from other ongoing PCMH pilot projects that involve more radical reforms to the larger delivery system reforms that place greater value on the essential role of primary care."

The research team also calls for the continuing evolution of the PCMH model, which they contend overemphasizes technology at the expense of the four core principles of primary care. Current and planned demonstration projects, they assert, must retain a balance of fundamental features of the PCMH that melds the core principles of primary care, relationship-centered care, reimbursement reform, and the chronic care model, as well as the emerging information technology that supports these elements.

Furthermore, they point out the need for individual physi
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Contact: Angela Sharma
asharma@aafp.org
913-269-2269
American Academy of Family Physicians
Source:Eurekalert

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