Why Half of Physician Practices Aren’t Meeting Medical Home Standards

October 21, 2011

Forty-six percent of physician practices don’t meet national standards to qualify as a "medical home" - but that could change if policy makers and practices take necessary actions.

While recently passed healthcare reform laws provide incentives to build medical home capacity with the goal of improving care and controlling costs, 46 percent of physician practices don’t meet national standards to qualify as a "medical home" - a practice that is able to manage ongoing care for patients and coordinate care among specialists and other healthcare facilities. 

According to a University of Michigan Health System-led study of more than 138,000 practices, "Adoption of Medical Home Infrastructure Among Physician Practices: Policy, Pitfalls, and Possibilities," larger multispecialty groups have a greater potential for meeting the National Committee on Quality Assurance's standards for medical homes. However, nine out of 10 Americans receive healthcare from physicians who practice in smaller, single-specialty groups - those practices that are struggling to meet medical home standards.

"Our study findings are particularly worrisome because the medical home model of care is seen as providing higher quality, more cost-efficient care" said John Hollingsworth, M.D., M.S., the lead author who conducted the study as a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan. "Ideally, medical homes will help keep patients with chronic diseases from getting lost in the shuffle of our complex, fragmented health care system, yet a growing number of patients do not have access to them."

The study’s findings aren’t surprising considering the transition to a medical home can be a big one.

In a recent podcast on medical homes, Sam Romeo, medical director for the Accreditation Association for Ambulatory Health Care, offered some historical perspective on the patient-centered medical home and factors to consider in transitioning your practice to this healthcare model.

Meanwhile, Hollingsworth and his coauthors are urging policy-makers "to address the challenges facing smaller practices" in order to "make the benefits of medical homes more equitable and widely accessible."

They suggest legislative incentives to help solo or small practices to affiliate with larger physician organizations, practice team-based care, and adopt health information technology. They also recommend initiatives that would enable regional centers to facilitate medical home reforms in less-populated areas.