Practice Management A Critical Part of Medical Home Concept

October 26, 2010

Patient-centered medical home pilot programs are being conducted across the nation with the goal of providing comprehensive primary care through partnerships. Practices considering embracing part of this collaboration have many factors to consider as to whether they fit into the concept, but strong practice management is key, according to one consulting firm.

The patient-centered medical home (PCMH) concept has emerged as a model aimed at controlling medical costs and fully serving patients' needs, and the idea is drawing great attention nationwide following its inclusion in the Affordable Care Act.

But while the concept of collaboration among healthcare professionals to treat the patient may seem straightforward, there are a lot of aspects to consider as to whether your practice can benefit from participating in a PCMH.

Chuck Moses, a practice enhancement facilitator, and Sheila Richmeier, co-director of practice transformation, both with Kansas-based practice consulting firm TransforMED, recently shared their company's view of the PCMH model, which they said differs in one key way.

"We feel the value of practice management is huge," Richmeier told attendees at this year's MGMA annual conference in New Orleans on Tuesday. "You need a strong practice manager."

While the firm's model also expresses the importance of aspects including access to care and information, care coordination, and health information technology, practice management is a crucial element to move a practice into the PCMH model revolving around the patient.

Components of strong practice management, according to Richmeier, are disciplined financial management, cost-benefit decision making, personnel/HR management, and revenue enhancement - all which go hand-in-hand with teamwork, communication, and leadership. The goal, said Richmeier and Moses, is to create a continuous relationship with a personal physician who can coordinate care for both wellness and illness.

But physicians can't do that work without their practice staff doing their jobs to facilitate another critical element to the PCMH - access to care. Richmeier admits this is the "toughest" part and "where most practices struggle." How do you free up your physician to see her patients when needed? It is the access part of the model that is crucial for success, she said.

Access to care is also linked with another PCMH concept promoted by TransforMED: the practice-based care team. It should be multi-disciplinary, physician-led, and allow members to function at their highest level, Richmeier said. That means freeing up physicians to do what they do best.

"Physicians went to school for a reason - to diagnose and treat patients," she said. "But with EHRs, for example, they are doing data entry, or answering phones. When you think about your practice-based care team, how can a team support a physician?"

Moses noted that the TransforMED model is one of many out there being used and tested in states nationwide to figure out the best way for healthcare stakeholders to work together to get patients the care they need while also hopefully trimming costs.

It is a framework for change, he noted, and being done, "in a way that has never happened before in primary care. We are all working together."

He admitted that PCMH is "an experiment," a sentiment echoed by Richmeier. "There are a lot of experiments and models across the country to see if they are right or not," she said. "This is still a work in progress." 

Keith L. Martinis associate editor at Physicians Practice. He can be reached at keith.martin@ubm.com.