Patient-centered medical homes gain momentum in half of states

Half of the country has moved toward patient-centered medical homes in the past six years, according to a Health Affairs study. Since 2006, 25 states have implemented new payment systems or revised existing ones in which primary care providers function as patient-centered medical homes. Of those, eight states reported their medical home efforts included team-based care, Hospitals & Health Networks reported.

Nineteen states said providers receive a monthly care management fee per patient; 14 states offer performance-based payments and four states issue shared savings based on multiple-payer participation. Even as more states hop on the patient-centered bandwagon, industry experts warn that physicians should ask questions about risks and independence before joining payers in medical home arrangements. "You want to be cautious and do more analysis rather than less," Phil Dalton, president and CEO of MDS Consulting in Torrance, Calif., and Costa Mesa, Calif., told American Medical News.

For instance, physicians should ask about their responsibilities, particularly if a payer embeds a case manager at the practice or hospital, the article noted. Nevertheless, many providers are satisfied with the new approach, according to a September report from the Primary Care Collaborative (PCPCC). Examples of PCMH programs not only showed that the model contributed to better health, improved care and lowered costs, but also improved satisfaction levels. Seattle-based health system Group Health of Washington, for instance, reported a 4.4 percent increase in provider satisfaction in 2009 to 2010, as well as lower emotional exhaustion reported by staff (10 percent versus 30 percent among controls).