What You Need to Know About Practice Transformation

In the race to put fee-for-service payments in the rear view mirror, patient-centered medical homes (PCMHs) are emerging as an important alternative care delivery model, and many family medicine practices are implementing the concept. Harry Strothers III, M.D., recently discussed with AAFP News how medical homes are revamping the delivery of health care in the United States and how physician practices can make the transformation to the new model. Strothers is professor and chair of the department of family medicine at the Morehouse School of Medicine in Atlanta and has a special interest in the PCMH model. His own practice has been recognized as a PCMH by the National Committee for Quality Assurance since 2012, and he writes and lectures extensively on the topic.

As past president of the Georgia AFP, Strothers played a key role in helping to launch the state's "PCMH University" using seed money provided by the chapter in 2010. Back then, four practices in the state were recognized as PCMHs. By 2013, that number had grown to more than 100.

Q: Expectations are high for patient-centered medical homes, but experts caution that it could take as long as five years to see noticeable results. What would you consider a reasonable timetable for results?

A: When a practice undergoes a transformation like (becoming) a patient-centered medical home, the results will vary in time from almost immediate to several years. While a well-planned and organized transformation can show results within months in terms of improved patient flow; staff and provider satisfaction; and efficient handling of labs, referrals and medication refills, seeing measurable results in care management and risk-stratified patient care can take years.

Q: What type of practice is the PCMH model best suited for?

A: While some aspects of the PCMH, like empowering staff to work at the full extent of their license or experience, can be applied to most practices, it appears that the model is best suited for practices in which most of the patients are interested in long-term continuity of care. The patients want to establish a relationship with the practice as long as they live in the area. Practices need to build and maintain relationships with patients over a period of several years to see real results. Trying to expand the practice with more patients who only visit once for an annual physical will not improve overall community health.