PCMHs see slower growth in ED visits, lower payment per beneficiary.
|Scooped by Texas Medical Association|
Promote the patient-centered medical home for every Texan
Consider that the costliest 1 percent of patients in the United State account for more than 20 percent of the nation’s health care spending. They are older patients with cancer, diabetes, heart disease, and other serious and chronic conditions. Many have multiple health problems and may not have relatives who can help with their care.
As public and private payers look for ways to reduce costs, improve patient outcomes, and ease barriers to access, they are turning to models of care that increase economic efficiencies and enhance patient care. One of these is the patient-centered medical home (PCMH). A PCMH is a primary care physician or physician-led team who ensures that patient care is assessable, coordinated, comprehensive, patient-centered, and culturally relevant. The physician or team directly provides, coordinates, or arranges health care or social support services as indicated by the patient’s individual medical needs and the best available medical evidence. The model uses a team-based approach, with the patient’s primary care physician leading the coordination of care. Trained teams and well-constructed electronic health records are keys to a successful PCMH.
TMA supports the use of the PCMH model in Medicare, Texas Medicaid, and commercial insurance plans. Given the budget constraints Texas faces and a growing population with unique health care needs, the PCMH offers the potential for Medicaid cost savings as well as improved patient outcomes and physician and provider satisfaction.