PCPs in patient-centered medical home practices more likely to use technology

Primary care physicians who worked in practices certified as patient-centered medical homes reported greater use of health information technology, according to a report from the CDC’s National Center for Health Statistics.

The CDC also said PCPs in patient-centered medical home (PCMH) were more likely to report on quality measures and to have more medical staff support than those in the certified facilities.

According to the CDC, a patient-centered medical home (PCMH) practice is an enhanced model of primary care delivery that is comprehensive and coordinated. The PCMH provides team-based care for all participants to reduce the cost of care, improve population health and improve patient experience. Such practices are also identified by comprehensive care through a team of providers, patient-centered and coordinated care, accessible services, and treatment focused on quality and safety. Eighteen percent of US PCPs work in certified PCMH practices.

Researchers cited several possible reasons for the increases found in the report.

“Interest in the PCMH model has increased as payers, including the federal government, have funded demonstrations and payment methods that support it,” Esther Hing, MPH, CDC survey statistician, and colleagues wrote. “The Innovation Center at the [CMS] has sponsored several demonstrations supporting practices in their efforts to become PCMH certified. In addition, payers, including CMS, are moving toward higher payment for those who are either PCMH certified or who demonstrate the provision of functions associated with a PCMH.”

Findings based on the survey of 4,096 physicians in 2013, investigators found the following:

•More PCPs in PCMH practices (68.8%) had at least one physician assistant, nurse practitioner or certified nurse midwife on staff compared with 47.7% of non-PCMH practices;

•More PCPs in PCMH practices (69.6%) reported electronic transmission as the primary method for receiving information on patients hospitalized or seen in EDs compared with 41.5% in non-PCMH practices; and

•More PCPs in PCMH practices (86.8%) reported quality measures or quality indicators to payers or organizations monitoring health care quality compared with 70.2% in non-PCMH practices.

Researchers wrote that the clinical effect these decisions had on patients was beyond the scope of the study.

“While this report describes functions available to [PCPs] in PCMH practices relative to those available to [PCPs] in non-PCMH practices, it does not compare outcomes for patients seen by physicians in PCMH practices with those seen by physicians in non-PCMH practices,” Hing and colleagues wrote.

However, other studies independent of CDC research indicate that on the clinical side, patients who receive care for common chronic diseases in PCMHs are more likely to adhere to their medication regimen as prescribed and that using the PCMH model in primary care improves adherence to chronic pain guidelines. Regarding administrative matters, a report in the Annals of Family Medicine suggested per-member-per-month and pay-for-performance payment models may be better strategies for PCMHs than fee-for-service.

The current CDC study also noted previous PCMH studies have been limited to federal qualified health centers, Veterans Administration clinics, family medicine practices and physician organizations. – by Janel Miller

Disclosure: Healio Family Medicine was unable to determine researchers’ relevant financial disclosures prior to publication.