Choosing a Business Model: Patient-Centered Medical Homes

Ryan Syrek, MA; Michael L. Munger, MD


May 03, 2016

Medscape: What would you consider to be the biggest challenges associated with PCMHs?

Dr Munger: In order to fully transform the delivery of care in the PCMH model, it takes time and resources. The implementation is an ongoing process. Teams take time to gel and work together efficiently as roles change. New additions to the care team also take time to work into the delivery process. Additional resources and personnel are necessary as roles, such as care coordinators or behavioral health professionals, are expanded and created.

The process also requires time from the physician or PCMH champion in the office to lead the transformation and develop the new processes to deliver care coordination, chronic disease management, and population health outreach.

Medscape: What do you see in the future for PCMHs?

Dr Munger: Advanced primary care delivery models are the future of our family medicine specialty. PCMH is specifically referred to as an alternative payment model in the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA) that was passed in 2015. We anticipate that upcoming payment reform from the Centers for Medicare & Medicaid Services will emphasize care delivery in a PCMH as the preferred practice model moving forward. Commercial payers in many markets are already providing care management fees and quality bonus payments for practices in a recognized PCMH. This trend will only expand in the coming years.

Medscape: What advice would you give to any physician considering a move to this practice model?

Dr Munger: Take a thoughtful and analytical review of your current practice. Look for opportunities to embrace the concepts of a PCMH, such as team-based care, advanced access for patients, care coordination, chronic disease management, and population health. Start on one or two of these aspects and begin incorporating them into your practice.

Do not feel the rush to "check the boxes" to become a recognized PCMH immediately. Instead, start the transformative changes that will lead to improved patient satisfaction and quality outcomes. As your practice transforms, the recognition process will be smoother and less burdensome.


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