Medical homes: A fix for our broken healthcare system

The healthcare system is broken; to fix it we need a new way of thinking about care delivery, healthcare industry experts said Friday at a briefing from the nonpartisan Alliance for Health Reform in the District of Columbia.

The patient-centered medical home (PCMH) offers that opportunity--it's more than just a single program or payment model, Amy Gibson, chief operating officer of the Patient-Centered Primary Care Collaborative said at the event, "Patient-Centered Medical Homes: The Promise and The Reality."

Highlighting our broken system and the need to coordinate care across the continuum, Pauline Lapin, senior advisor at the Center for Medicare and Medicaid Innovation, shared her father's experience, a 79-year-old man with six chronic conditions who takes more than 20 medications and vitamins.

Given his medical needs, which involve a range of different providers, Lapin and her sisters decided he should see doctors within one system and co-located in the same building. "What we discovered was no one talks to each other," Lapin said.

While her father has three daughters--a CMMI adviser, a pharmacist and nurse practioner--to coordinate his care, most Medicare beneficiaries aren't that lucky. That's where the PCMH comes in. The PCMH breaks down the silos between providers, hospitals and insurance companies.

One example is the CMMI's Comprehensive Primary Care Initiative (CPC), which fosters collaboration between public and private payers and incentivizes primary care doctors to better coordinate care for their patients. Participating practices must improve their use of data and health IT, as well as provide five comprehensive primary care functions: access and continuity, planned care for chronic conditions and preventive care, risk-stratified care management, patient and caregiver engagement, and coordination of care.