New Report Highlights Savings Achieved by Medical Homes

Rahul Rajkumar, M.D., J.D., received a call one Friday evening from a family member who said she was taking medication for a urinary tract infection and had a fever of 103 degrees.

Rajkumar, a primary care physician and acting deputy director at CMS' Center for Medicare and Medicaid Innovation, initially considered telling her to go to the ER, given the time. Then he discovered that her primary care physician in southwest Ohio was participating in the Comprehensive Primary Care initiative.

"I said, 'Why don't you call your doctor and see what happens?'" Rajkumar recalled.

The patient called her physician's office and was transferred to a triage nurse who discussed her condition and told her someone would call back within 30 minutes. A nurse care manager called back soon afterward. From her home, the care manager reviewed the electronic health record . She advised the patient to switch her medication from Cipro to Bactrum and to drink Gatorade overnight.

The medication change proved effective, and the entire exchange was conducted entirely by telephone, said Rajkumar. Notably, he added, "A trip to the emergency room was averted."

Speaking during a recent forum hosted by the Patient-Centered Primary Care Collaborative (PCPCC) to discuss its new report, The Patient-Centered Medical Home's Impact on Cost and Quality(www.pcpcc.org), Rajkumar said the experience highlights the potential of patient-centered medical homes (PCMHs). In this setting, a patient can receive a consultation after normal office hours, medical professionals have easy access to electronic records and decisions about care can be made without a hospital visit.

"It's an extraordinary time in health care transformation," Rajkumar said. "Not only is primary care at the center of the medical home model, it's a winning strategy in any transformation effort."