The patient-centered medical home is "a model for care provided by physician practices aimed at strengthening the physician-patient relationship."

2. Change is Hard . . .

4. Presentation Outline

5. What is a Patient Centered Medical Home (PCMH) The patient-centered medical home is "a model for care provided by physician practices aimed at strengthening the physician-patient relationship by replacing episodic care based on illnesses and patient complaints with coordinated care and a long-term healing relationship." (NCAQ) A recent Journal of General Internal Medicine provides a core definition of the PCMH as a team of people committed to improving the health and healing of individuals in a community.

6. According to the ACP, it is:

8. Based on the Joint Principles Team-based care: NP/PA RN/LPN Medical Assistant Office Staff Care Coordinator Nutritionist/Educator Pharmacist Behavioral Health Case Manager Social Worker Community resources DM companies Others…

9. Principles were created by the

10. Referred to as the Patient Centered Primary Care Collaborative (PCPCC) PCPCC on the web: http://www.pcpcc.net

11. Critique of the PCMH: Some feel it doesn’t go far enough

12. Presentation Outline

13. How do you Know a PCMH When you See One?

14. Recognition Programs for PCMH Developed or Under Development Quality Organizations PCMH Standards Activity 2010

16. Key Points for Level 1 PCMH

17. Level 2 -> Level 3

18. More Features of a PCMH Practice

19. NCQA Recognition Activity SOURCE: NCQA, July 2010

20. SOURCE: NCQA, December 2009

22. Presentation Outline

24. Specialty Care Connections * FAQs available at: http://www.acponline.org/ running_practice/pcmh/understanding/specialty_physicians.htm

25. Patient Centered Medical Home Neighbor (PCMH-N) Draft Definition A specialty practice recognized as a Patient Centered Medical Home Neighbor (PCMH-N) engages in processes that: These processes would take the form of service agreements (compacts) between/among the participating practices.

26. Presentation Outline

27. Combined Commercial and Medicaid/CHIP PCMH Activity = Identified to have at least one private payer medical home pilot under development or underway = Identified to have a Medicaid and/or CHIP medical home initiative = Identified to have both a private payer and a Medicaid and/or CHIP medical home initiative * As tracked by the American College of Physicians (updated March 2010)

28. Federal PCMH Efforts For more information on CMS/Medicare PCMH Efforts: http://www.acponline.org/running_practice/pcmh/demonstrations/index.html

29. Federal PCMH Efforts (cont.)

30. Safety-Net Medical Home Initiative Source: http://www.qhmedicalhome.org/safety-net/index.cfm

31. Common Practice Support Approaches in PCMH Demos

32. Presentation Outline

33. Evaluation Collaborative sponsored by Commonwealth

34. Community Implications - Published Results of PCMH Projects to Date Source: PCPCC Pilot Guide, 2009

35. Community Implications – Published Results of PCMH Projects (cont.) Source: PCPCC Pilot Guide, 2009

37. Community Implications Source: Metcare Press Release, February 23, 2010

38. Estimates on Co$t? Future of Family Medicine Report ( http://www.annfammed.org/cgi/reprint/2/suppl_3/s1 ), 2004 Deloitte: The Medical Home, Disruptive Innovation for a New Primary Care Model ( http://www.deloitte.com/dtt/cda/doc/content/us_chs_MedicalHome_w.pdf ), 2008

39. What Does it Co$t? AMA ( http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/medicare/ruc-medicare-medical-home-demonstration-project.shtml ), 2008 Urban Institute Report - Co-Funded by The Commonwealth Fund and ACP – Available at: http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Oct/Incremental-Cost-Estimates-For-The-Patient-Centered-Medical-Home.aspx , 2009

40. Presentation Outline

42. Presentation Outline

45. Network for generating & disseminating good ideas

52. Acknowledgements Shari M. Erickson, MPH Senior Associate, Center for Practice Improvement & Innovation Tom Bodenheimer, MD UCSF Katie Coleman, MPH MacColl Institute Jim Mold, MD U of Oklahoma

54. Thank you