Massachusetts to Receive $500,000 to Support Patient-Centered Medical Homes

The Patrick Administration announced in early June that Massachusetts will receive $500,000 in grant funding to support the transformation of 14 Community Health Centers into “patient-centered medical homes” over a four-year period. The Medical Home model is designed to provide a single point of coordination for all health care, including specialists, hospital, and post-acute care. Practices that qualify as Medical Homes receive supplemental payments to compensate them for their services. The primary care physician acts as the facilitator and manager of the patient-centered care, and coordinates all levels of care, including care provided by other specialist physicians. The rationale for the model is that this coordination can reduce fragmentation in patient care in ways that lower costs and lead to better overall patient outcomes. The model is endorsed by the American College of Physicians, the American Academy of Family Practitioners, the American Academy of Pediatrics and the American Osteopathic Association.

Proponents of medical homes believe care coordination facilitates the provision of recommended services, eliminates redundancies or unnecessary care, and encourages increased communication with patients as well as patient adherence to provider care regimens. The idea is that coordinated care is more cost-effective and more beneficial to the patient than fee-for-service delivery models, which encourage independent care and greater healthcare consumption. The model intends to help physicians better understand patients’ needs and eliminate unnecessary tests, hospital stays, and additional visits to specialists. The model is expected to be especially beneficial for children, adolescents, and persons with chronic conditions who require a constellation of services and sometimes require frequent monitoring. The intention is that existing primary care practices would be able to scale-up their services to achieve Medical Home standards relatively easily. In addition, the model may encourage a greater number of medical students to choose a career as a primary practitioner. Massachusetts ’ funding will primarily support the “medical facilitator” role for centers, including “practice coaches,” highly trained clinicians who will help health centers transform themselves into the new models of care.

The 14 Massachusetts sites selected for inclusion in the patient-centered medical home project are:

The grant funding is provided through a Safety Net Medical Home Initiative led by the Commonwealth Fund of New York and implemented by Qualis Health. The Commonwealth Fund is joined in support of the project by regional co-funders. In Massachusetts, the co-funders include Partners HealthCare, The Boston Foundation, Blue Cross Blue Shield of Massachusetts Foundation, and Beth Israel Deaconess Medical Center.

In addition to the $500,000 in grant funding, the Commonwealth will receive technical assistance from Qualis Health, a health improvement organization, working in concert with the MacColl Institute for Health Care Innovation. Participation in the program also includes a comprehensive evaluation by the University of Chicago. Furthermore, the funding will complement support for the use of health information technology, consistent with ongoing efforts in Massachusetts as a part of the state’s landmark health care reform.

Several potential barriers may impede success of the Medical Home Model. Physicians serving as medical homes may also have a limited ability to coordinate care in certain settings outside their scope of practice. Since payment approaches are typically targeted to primary care physicians, hospitals and specialists outside the Medical Home have few incentives to collaborate with the primary care physician (Fisher, 2008). For a more detailed analysis see http://www.mass.gov/Eeohhs2/docs/dhcfp/pc/2009_02_13_Medical%20Home.pdf.

-From: “ SUMMARY: MEDICAL HOME MODELS” Mathematica, Inc., The employee owned parent company of Mathematica Policy Research, Inc. and the Center for Studying Health System Change at http://www.mass.gov/Eeohhs2/docs/dhcfp/pc/2009_02_13_Medical%20Home.pdf, and “ Massachusetts to Receive $500,000 to Support Patient-Centered Medical Homes” June 05, 2009 http://www.mass.gov/?pageID=eohhs2pressrelease&L=1&L0=Home&sid=Eeohhs2&b=pressrelease&f=090605_medical_homes&csid=Eeohhs2 retrieved 7/21/09.

 

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