The Commonwealth Fund report calls on all providers to take steps to create medical homes for patients, especially among safety net providers. The researchers also call on physicians and policy makers to establish standards for medical homes and promote public reporting of performance.
The American College of Physicians has also been selling the idea of the "patient-centered" medical home. The organization issued a joint principles statement with the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Osteopathic Association in February outlining the elements of a patient-centered medical home. ACP and AAFP officials are also in discussions with employers and payers to begin pilot projects testing the concept of the medical home, some of which could launch this year.
The findings of the Commonwealth Fund report were praised by Dr. Rick Kellerman, AAFP president, who called the results "outstanding and not unexpected." The findings showcase how important the medical home is, and add to the long list of reasons for changing how care is provided and paid for, he said.
Demonstration projects are also in the works at the federal level. As part of the Tax Relief and Health Care Act of 2006, Congress has authorized a 3-year demonstration project in eight states that would provide a care management fee to physicians who coordinate care as part of a medical home. That Medicare demonstration project is expected to launch in 2009.
Other pieces of legislation being considered by Congress contain references to the medical home and the need to coordinate care, Dr. Dora L. Hughes, health policy adviser to senator and presidential candidate Barack Obama (D-Ill.), said at the press briefing. But the real barrier to making the medical home more widespread throughout medicine is the reimbursement system, she said.
Physicians aren't reimbursed for coordinating care, answering patient e-mails, conducting telephone consultations, managing chronic diseases, or implementing health information technology. And primary care is generally not well paid, she said.
ELSEVIER GLOBAL MEDICAL NEWS