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“Home” Improvement

“Home” Improvement

The idea of a “Patient Centered Medical Home” seems to be referenced constantly within the health care quality world.  There’s discussion of whether or not it will work, how it will be implemented, what the cost will be and so on.  All of this happens while patients by and large have no idea what the term is and what a system that embodies this idea would mean for them.

In a Patient Centered Medical Home (PCMH) a patient would have better coordinated services by using their primary care provider as a sort of “one-stop-shop” for all of their medical needs.  Some might argue that this is done to a certain extent already, but in a PCMH model patients would receive even greater attention from their primary care practice in the form of improved chronic care management, increased access to services, and better communication.  All of these things seem like they would be wins for patients and I think that if most people knew that this was the kind of system we were heading towards they would be pleased.  However, it’s not going to be an easy transition for a number of reasons.

For starters, we’ve got a fairly complex and, at times, surprisingly fragmented health care system where physicians, specialists, pharmacists, hospitals, and insurance companies are communicating with one another using an antiquated system.  Although easing this burden is precisely one of the goals of the PCMH model and the increased funding for electronic medical records, it is not going to be an easy transition.

I’ve also heard many experts acknowledge that there is a problem with the name itself.  As a society we’ve tried to soften ideas in the past with the “Home” title.  “Nursing home” and “funeral home” are two that spring to mind for most.  Thankfully though, the phrase “Patient Centered Medical Home” is just that, a phrase.  The concept should still ring true for consumers and providers alike once experts begin to articulate the benefits of a system such as this.

We are lucky to be in a state like Pennsylvania that is currently leading the way in advancing a patient-centered model like the one outlined here.  Through a state-run commission, we have been able to bring together consumer organizations, medical societies, public and private insurers, hospitals, and individual primary care practices to have a dialogue and work through the necessary changes and overcome potential barriers.  However, The Chronic Care Commission as it has been referred to, is set to expire this year unless legislators realize the potential cost savings and improvement at stake and reauthorize the program.  In an upcoming entry I’ll attempt to outline some of the work of the Commission and discuss the benefits of such a program for patients.

In the meantime if you’d like for information please visit:

The Pennsylvania Campaign for Better Care Webpage


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