The care coordination of an AIDS patient and his HIV-positive wife managed by UMass Medical School’s Judith Steinberg, MD, MPH, is a textbook example of success using the patient-centered medical home (PCMH) model, according to a cover story in the most recent issue of Medical Economics.
Dr. Steinberg (at right), clinical associate professor of medicine and deputy chief medical officer for UMass Medical School’s Commonwealth Medicine division, said that it was critical to have a behavioral health specialist immediately begin counseling the couple following their diagnosis.
That coordination would not have existed if Steinberg’s practice was not a medical home, one of 44 participants in the multi-payer Massachusetts Patient-Centered Medical Home Initiative (MA-PCMHI) sponsored by the Massachusetts Office of Health and Human Services.
“When I describe the patient-centered medical home to practices, providers, or to anyone—all of us are patients at one point or another—I like to say it’s really the way we, as patients, would like to see our care delivered,” Steinberg told Medical Economics.
“It makes such perfect sense that our care is focused on us as an entire individual, not as individual diseases or organ systems. That our care is well-coordinated and communicated across many settings and there’s an attention to quality and we are all partners in our care.”
The article, “Patient-centered medical home: Making care coordination work for your practice,” also included insight from Christine Johnson, PhD, PCMH quality improvement and transformation director at Commonwealth Medicine. She described how a physician reluctant to use care managers grew to appreciate them after they assisted in handling a complicated post-hospitalization patient. The physician said it was like “going from baggage to first class,” Johnson said.
Commonwealth Medicine is leading the development of the patient-centered medical home model and helping practices turn it into a reality. Led by Steinberg, Commonwealth Medicine has partnered with Bailit Health Purchasing LLC on MA-PCMHI. The three-year multi-payer demonstration concluded on March 31, 2014 and is in the analysis stage. Early results show 43 of 44 practices received National Committee for Quality Assurance PCMH recognition. Statistically significant improvement was shown in 11 of 22 clinical quality measures, including chronic disease management, prevention and care coordination. A complete evaluation and report is expected in the fall of 2014.
Read the full Medical Economics article: Patient-centered medical home: Making care coordination work for your practice
Related links on UMassMedNow:
Steinberg in Boston Globe op-ed: Patient-centered medical homes for homeless exemplify how to improve health care
New primary care model seeing results in Massachusetts: Commonwealth Medicine helps to lead medical home demonstration project
Transforming primary care by putting the patient first: UMMS and Commonwealth Medicine advancing Patient-centered Medical Home Initiative