AJMC Authors Find Medical Home Produces Little Effect on Patient Experience Within VA

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The “Patient-Centered Medical Home,” which promises better coordination of care for those with multiple medical conditions, has been touted as a vehicle for improved health, satisfaction, and cost-savings: the so-called triple aim. A study of PCMH adoption within the Veterans Health Administration found little effect on patient satisfaction, at least in the early going.

The study of the Patient Centered Medical Home initiative within the VA appears in the June issue of The American Journal of Managed Care.

Results may represent the complexity required to measure and implement the medical home in practice, the authors write.

Early results of widespread adoption of the Patient-Centered Medical Home (PCMH) model within the Veterans’ Health Administration did not show evidence of improved patient satisfaction, one of the model’s core aims, according to a study published this month in The American Journal of Managed Care.

Authors of the study, Ashok Reddy, MD, Anne Canamucio MS, and Rachel M. Werner, MD, PhD, examined the implementation of a PCMH model across 56 sites involving more than 30,000 patients; they found that the share of medical home providers rose from 8.2% in 2010 to 81.1% in 2012. During this period, there was a seven-fold increase in adoption of eight of nine of the structural measures of a medical home. The full study is available here.

However, the authors did not find improvement in patient experiences of care. Of note, patients gave comparatively poor ratings in areas such as “getting care quickly” (44.1%) and “getting needed care,” (47.0%) and higher ratings in “overall quality of personal doctor/nurse,” (76.9%). Other ratings were “how well they communicated,” (58.9%) and “overall rating of VA,” (65.2%).

The authors note that studies of PCMH implementation have produced mixed results, and that the findings at the VHA may reflect the growing pains of putting such a system in place on a large scale. Results, they write, “may simply represent the complexity required to measure and implement the medical home in practice.”

About the Journal

The American Journal of Managed Care, now in its 20th year of publication, is the leading peer-reviewed journal dedicated to issues in managed care. Other titles are The American Journal of Pharmacy Benefits, which provides pharmacy and formulary decision makers with information to improve the efficiency and health outcomes in managing pharmaceutical care. In December 2013, AJMC introduced The American Journal of Accountable Care, which publishes research and commentary devoted to understanding changes to the healthcare system due to the 2010 Affordable Care Act. AJMC’s news publications, the Evidence-Based series, bring together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.

CONTACT:    
Nicole Beagin (609) 716-7777 x 131
nbeagin(at)ajmc(dot)com
http://www.ajmc.com

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