PCMH care model gaining acceptance in primary care, specialist practices

Primary-care physicians play a pivotal role in assuring that patients who require specialized care are transitioned properly from one clinical environment to another to help lower the risks for adverse events and repeat hospitalizations, according to a health quality management expert who spoke today at the National Quality Summit sponsored by the National Association for Healthcare Quality (NAHQ, www.nahq.org).

Transitions in care can be broadly defined as practices implemented across the continuum of care, such as within a healthcare delivery organization, across settings (e.g. acute to post-acute) and within a community or population. For its first-ever National Quality Summit, NAHQ assembled a prestigious roster of health quality authorities to discuss best practices for assuring favorable outcomes at every stage in the care transitions continuum.

In 2009, the Journal of Hospital Medicine reported that 1 in 5 patients discharged from a hospital to the home experienced an adverse event within three weeks, and the National Quality Forum found that preventable hospital readmissions that occur within 30 days of discharge cost Medicare $15 billion a year. Further, according to the Annals of Internal Medicine, the cost of poor discharge planning is estimated between $14 and $44 billion a year.

"Implementing strategies to lower hospital readmission rates is critical for improving quality and patient safety and reducing healthcare costs. Numerous studies have shown that quality transitions in care are one method to reduce readmission rates," said NAHQ
Summit Chairman Eric A. Coleman, MD, MPH, professor of medicine and director of the Care Transitions Program at University of Colorado Anschutz Medical Campus.

Summit speaker Neil Kirschner, Ph.D., senior associate, regulatory and insurer affairs, American College of Physicians, said Medicare and other health insurance providers expect primary-care practitioners and specialists to be responsible for managing care transitions. No small task, says Kirschner, considering a typical doctor deals with more than 100 different medical practices.