Healthcare :: Test project of patient-centered medical home model endorsed by American College of Physicians

The American College of Physicians (ACP) this week endorsed a test project of a Patient-Centered Medical Home (PCMH). The project, to be conducted in Florida, will combine the resources of the UnitedHealth Group (UHG), the American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP) with ACP to test a model that has the potential to dramatically improve healthcare delivery and quality.

The project will be a test of the PCMH model implemented with the financial and administrative support of a private health plan. The innovative model is designed to strengthen the physician-patient relationship by having a personal physician coordinate a team of healthcare professionals as they address the full range of a patient?s healthcare needs.

?We are excited to conduct this PCMH test in Florida,? said Malcolm Foster, Jr., MD, FACP, one of the governors of the ACP Florida chapter. ?The PCMH model describes the environment in which internists want to practice. This pilot will provide additional payment and other practice-level assistance to help support that environment.?

The pilot project will focus on six small and mid-size physician practices, each with general internists. The practices will have a minimum threshold of patients insured by UnitedHealth Group. Those patients will have the option to participate in the project.

Practices will have to demonstrate that they have capabilities?in both infrastructure and personnel?to provide patient-centered care. Enhanced payment will be given to primary care doctors whose care is based on the model and who demonstrate measurable improvements in the overall health of patients.

?This is what physicians-in-training signed up for when they elected to become internists and this is the care that patients want and deserve,? Kay Mitchell, MD, FACP, the other ACP Florida chapter governor, said. ?The PCMH has great promise for overcoming many of the challenges ? including quality, patient satisfaction and overall cost ? of our healthcare system. We are pleased to have the opportunity to contribute toward solutions both immediately in Florida, and longer-term throughout the country.?

UnitedHealth Group will provide additional payment and practice support to the participating practices. The additional payment recognizes the extensive work that the physician does related to a patient?s care outside of the direct physician-patient interaction in the office setting and further facilitates the physician?s ability to work with other physicians and professionals to meet the patient?s needs and preferences. Further, UHG will provide in-kind support to enhance the practice capability ? including using an after-normal-business-hours nurse triage telephone service, accessing an electronic tool, and providing a registry ? to manage patient populations, which in turn will increase the ability to provide timely clinical interventions. The additional payment and support are meant to help participating practices maintain and expand their PCMH capability.

Insurers, employers, and policymakers have expressed interest in the PCMH and its potential to enable meaningful healthcare reform. The Florida pilot project experience, especially the results, will help determine how to refine and expand the use of the PCMH.

ACP this week commended UHG for its decision to use an outside entity to help develop the metrics on which the pilot project will be evaluated and to evaluate the project?s outcome. Enlisting the expertise of an external evaluator will enhance the methodology used to evaluate the project and increase stakeholder confidence in the results.

David Dale, MD, FACP, ACP president, said, ?The UHG test project provides a vehicle to apply the PCMH concept in the real-world environment and to determine how practices can best use the capability and payment that supports it to improve patient care and demonstrate value for the healthcare system.? Dr. Dale also noted that, ?ACP is pleased with the tremendous amount of stakeholder interest in the PCMH model and applauds UHG for being at the forefront of testing the model.?

The ACP, AAFP, AAP, and the American Osteopathic Association collectively released a set of principles that define the PCMH in February 2007. ACP and the other professional organizations are pursuing additional opportunities to test the PCMH in accordance with those principles.

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