Patient Centered Medical Homes : Patient Care And Contractual Services

Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.

Overview of the Patient Centered Medical Home project piloted by Geisinger Health System in Danville, Pennsylvania

It takes a team approach to manage patient-care. As a FNP, and a provider for this

It is a fact that patients who do not have access to primary care tend to delay seeking treatment until they are seriously ill. These delay results in poor health outcome and higher health care cost. It is critical that increased funding be allocated for Community Health Centers. Over the long run, investing in these centers ultimately reduces health care cost, improve patient welfare, outcomes and reduce budget allotment for healthcare.

One of the aims of the Patient Protection and Affordable Care Act (ACA) of 2010 is improved integration and coordination of services for primary patient care. The patient-centered medical home (PCMH) is one of the approaches by which improvements can be established. The patient-centered medical home model is particularly well-suited for people who have chronic illness. The design of the patient-centered medical home model departs substantively from traditional reimbursement policies, in that, the ACA provides for incentives and resources to enable care coordinators to be directly recognized and compensated for their care coordination work. Care coordinators are most often registered nurses who through their work that aligns with ACA engage in quality improvement work, cost-effectiveness measures, and patient advocacy. To bring the ACA model to a human scale, the authors present a case study of a care coordinator at a patient-centered medical home in rural Maine. The table provided below provides a basic textual analysis of the study as it is published in the professional nursing journal.

The patient- centered medical home is designed to improve quality of care through a team-bases coordination of care, which would treat the majority of a patients needs at once by increasing access to care and empowering patients to be a part of their own care (U.S Department of Health and Human Services, 2014). In order for these homes to work, the authors suggest that specialists might be the best candidates to certain conditions, however for these specialist to function in the capacity that is needed in these medical homes, they would have to have interest and proficiency to manage other conditions that fall outside of their

Interdisciplinary team work is extremely important to ensure patients receive quality care that meets their individual needs (Nancarrow, et al, 2013). To achieve this a group of health care professionals work together by bringing their different professions, assessments and evaluations together in order to design a care plan for treatment of the patient (Korner, 2010). For example if a patient is dealing with a mental health disorder such as depression or schizophrenia, the interdisciplinary team would consist of the doctor, nurse, psychologist, psychiatrist, pharmacist and neurologist. The roles and responsibilities of each team member must be based on their scope of practice including the assessment of the patient, the treatment to be given,

Professional associations, payers, policy makers, and other stakeholders have advocated for the patient-centered medical home model. Interventions to transform primary care practices into medical homes are increasingly common, but their effectiveness in improving quality and containing costs is unclear.

The Patient-centered Medical Home (PCMH) will be assessed to evaluate the effectiveness of other health care organizations (HCOs) to compare and contrast values and mission. In addition, program cost-effectiveness will be examined considering health insurance providers and HCO. As a health care administrator, it is beneficial to truly understand the basis and goals of the PCMH to effectively execute the medical home model and successfully provide the best care for each patient.

PCMH is an approach to providing comprehensive primary care to adults, youth and children. PCMH will broaden access to primary care, while enhancing care coordination. Its principles are collaborative care, patient- driven, utilization of a pharmacist, efficient, continuous care to acute, chronic, preventive, and end of life care, flexible, measurable outcomes, aligned payment policies.

The author has been employed in the healthcare field for over fifteen years that has allowed the time to observe the transformation of the primary care practice. This paper will examine the industry using Aspirus, Inc. as the reference point; however encompassing an examination of other healthcare institutions. Evidence suggests the Patient Centered Medical Home (PCHM) model, also known as the medical come, of care can offer many benefits, including improved quality in the patient experience and disease management and lower costs to the patient and system because of reduced emergency room visits or hospital admissions. The main objective of this paper is to highlight the challenges and explore what the PCMH model will be like in five years within the primary care setting of a healthcare organization.

The patient centered medial home also abbreviated as PCMH is a care delivery model. This model ensures that patient treatment is arranged by their primary physicians to make sure that they will receive the obligatory treatment care. It is imperative that the patient receive required treatment and care when is it suitable and at any timely given manner.

The patient-centered medical home model is a framework developed by the Agency for Healthcare Research and Quality aimed at improving and transforming how primary care is organized and delivered. The patient-centered medical home model has five core functions: Comprehensive Care, Patient-Centered, Coordinated Care, Accessible Services and Quality and Safety. Comprehensive Care involves the utilization of a diverse team of care (physicians, nurses, nurse practitioners, therapists, pharmacists, community health workers, social workers, case managers, educators, nutritionists, etc.) in order to meet all of the patients health care needs including physical and mental health, prevention and wellness, acute care and chronic care. Patient-Centered Care recognizes the importance of the patient in their care and developing a partnership with the patient when developing care plans. Coordinated Care emphasizes the need for coordination of services and communication among different service providers during the transition of care. Accessible services focuses on timely and responsiveness to patients by reducing waiting times and implementing telehealth communication. Finally, Quality and Safety refers to the commitment of quality improvement through the use of evidence-based medicine and clinical decision-support tools15. All aspects of the patient-centered medical

Coordinated care with health care providers, nurses, and case managers to assist in delivering quality patient care.

The purpose of this essay is to provide a review of the models which are Chronic Care Model and Patient-Centered Medical Home Model. Also to provide how both achieve quality and safety and add as much information on how both models benefit in providing care to the patients.