The Patient Centered Primary Care Collaborative has released The Purchaser Guide to the Patient-Centered Medical Home, a handbook for understanding the medical home model.
The PCPCC is a coalition of business leaders, consumer groups, organizations representing primary care physicians and other healthcare stakeholders. Studies of the PCMH model show that it improves patient satisfaction and clinical outcomes, thus lowering healthcare costs by improving care coordination and communication between primary care physicians and their patients.
"Employers as purchasers have the leverage to push for transformative change in the way we finance healthcare to bring about better care delivery," said Edwina Rogers, PCPCC's executive director and vice president of health policy for The ERISA Industry Committee. "The Purchaser Guide sets out the clear advantages of the PCMH model for both employers and consumers and provides the tools to take action today."
The guide was developed over a six-month period by one of the PCPCC's four working groups, the Center for Benefits Redesign and Implementation, and offers five case studies of PCMH initiatives that include 21 summary examples of PCMH models in operation through the United States. One case study in North Carolina saved the state's Medicaid program approximately $124 million in a single year, according to officials.
"The Purchaser Guide was conceived as a blueprint for employers on practical action steps that they can take to advance patient-centered primary care," said Andrew Webber, NBCH's president and CEO. "I urge swift adoption by employers everywhere if we are to reverse the current erosion of primary care and reorient our healthcare system towards health promotion, disease prevention and chronic care management."
The guide offers a definition of the medical home concept and advantages of its implementation for employers based on effectiveness for improving outcomes and lowering healthcare costs, according to officials. A central impetus of the guide is to spur employer activity.
One section illuminates a three-step "jump start" to help employers, plus six strategies purchasers can use to advance the PCMH model:
1. Participate in a regional pilot;
2. Incorporate PCMH into insurer procurement and performance assessment;
3. Align payment strategy with PCPCC adoption objectives;
4. Build coalitions in support of PCMH;
5. Engage consumers; and
6. Integrate PCMH into other corporate health strategies.
The guide includes sample insurance contract language and a Request for Information (RFI) document designed to assist purchasers who want to work with health plans to advance PCMH.
"Employers are on the front lines when it comes to rising healthcare costs, and it's in our best interest to ask key questions when we purchase coverage on behalf of employees and align our payment practices to expand the reach of PCMH," said Paul Grundy, MD, chairman of the PCPCC and director of Healthcare Transformation and Strategic Initiatives at IBM. "Primary care physicians will play a primary role in this transformation. We need structures that help them become more accessible and proactive in care coordination and disease prevention."