There’s a great seafood shack in Kittery, Maine. My husband and I recently drove up from Boston for our periodic lobster roll fix, and just as we crossed the border, a sign caught my eye: “Welcome to Maine, the way life should be.”
For a moment, my thoughts shifted from the decadence of our future lunch to a different way of life — where the frenetic pace found in big cities melts away. Later, as I watched the buttery goodness of my lobster roll slowly disappear, I thought to myself — sometimes quality is better than quantity.
Some primary care and community practices are drawing the same conclusion. Under the pressures of declining reimbursements within a fee-for-service payment model, many have increased transaction volume to maintain steady revenues. Shorter visits. Longer hours. It seems to me it’s time for a change that puts the spotlight on care quality.
One promising development is the “Patient-Centered Medical Home” (PCMH). Despite its name, PCMH is not a physical place but rather an approach to delivering healthcare. I think of it as what primary care aspires to be, and the model is gaining momentum.
PCMH pioneers like award-winning Ammonoosuc Community Health Services have demonstrated that the approach not only helps improve patient outcomes but also helps reduce system-wide costs – significantly. In fact, PCMHs have been so successful that the Centers for Medicare and Medicaid Services as well as many private insurers are offering financial incentives for practices to adopt this approach.
Under the PCMH model, the primary care provider coordinates integrated, evidence-based care with a team of healthcare professionals who value collaboration and continuous improvement. Care teams take a holistic view of patients and the varied, sometimes nontraditional, factors that can influence outcomes, and patients play an active role in their own care.
Though it may not sound radical, the model actually requires a new way of operating – a cultural shift, and technology can help with that transition. With the growing acceptance of EMRs, healthcare is now poised to embrace this change.
Why is the model so effective?
1. Collaboration enhances care. PCMHs are learning that the body is not a collection of independent systems – the body is the system. One provider’s care can impact the effectiveness of another’s, particularly in complex cases. Some of today’s EMRs make it easier than ever for providers to have a full view of their patient and actively collaborate across care systems on an integrated care plan.
2. Clear metrics help align goals. Disagreements over the cost-effectiveness of care have left payers and providers on opposite sides of the negotiation table for years. EMRs can help providers demonstrate clinical and financial results to payers in a way that wasn’t practical in the paper world.
3. Success breeds success. The PCMH model embraces continuous improvement. EMRs with strong analytics and the ability to benchmark outcomes help teams identify ways – whether simple or profound — to improve the care model. EMRs best suited for PCMH also have adaptable workflows that help providers incorporate those lessons more quickly into daily practice. Watching metrics improve inspires teams to continue enhancing care.
What is really interested about the PCMH model is its potential to help drive additional patient demand. I didn’t dare share the name of my favorite seafood shack earlier because the restaurant is already quite busy, but good things are hard to keep secret. Once patients understand the benefits of a patient-centered medical home, I expect to see demand at those practices increase. Maybe quality leads to quantity. It will be an interesting trend to watch…after another lobster roll in Maine.
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