The tiny gains of patient-centered medical homes. Are they worth it?

First, a history lesson. Back in the mid-2000 oughts, the AAFP launched a wholly owned subsidiary called TransforMed. It was originally started to help practices implement the “new model of care” from the Future of Family Medicine Report. Soon after it was launched, the joint principles of the patient-centered medical home (PCMH) were announced, so TransforMed pivoted to help practices implement the PCMH model of care. In one of the major blunders the AAFP has committed over my career, it set up an experiment called the National Demonstration Project (NDP). An experiment was a great idea. How they carried it out was an example of supreme hubris. The enrolled 36 practices and randomized 18 of them to receive coaching on how to transform to a PCMH and the other 18 were left on their own to figure it out for themselves. Do you see the gargantuan mistake they made? Instead of testing whether or not the PCMH was a good idea in the first place, they just assumed it was great and went about testing how best to create the beast. You know where this is going. A study of the NDP practices found that there wasn’t much difference in outcomes whether the practice was coached or not, and there was practically no difference in quality (5% change in mostly meaningless metrics) and no difference in costs or patient experience in these practices over 26 months of follow up. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation:...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Policy Primary Care Public Health & Source Type: blogs