Patient-Centered Medical Home Initiative Produced Modest Economic Results For Veterans Health Administration, 2010–12

In 2010 the Veterans Health Administration (VHA) began a nationwide initiative called Patient Aligned Care Teams (PACT) that reorganized care at all VHA primary care clinics in accordance with the patient-centered medical home model. The researchers in this article published in Health Affairs analyzed data for fiscal years 2003–12 to assess how trends in health care use and costs changed after the implementation of PACT. They found that PACT was associated with “modest increases in primary care visits and with modest decreases in both hospitalizations for ambulatory care–sensitive conditions and outpatient visits with mental health specialists.” The researchers found that the PACT … Continue reading

PCPCC Map of PCMH Activity across states

The Patient Centered Primary Care Collaborative (PCPCC) published patient centered medical home (PCMH) activity through state programs across the United States. Each state page includes a checklist of potential programs states can use to expand PCMH activity (e.g., legislation, regulations, grant-funded demonstration programs, etc.), a listing of PCMH programs grouped by public, private and/or multi-payer type, evaluation data, population health data and statistics, and state-specific news.   Compared to other states, Virginia has a low level of PCMH activity through state programs. This does not mean that there are fewer PCMH recognized clinicians/practices in Virginia, but rather it speaks to state … Continue reading

Out-of-Pocket Healthcare Expenditure Burdens Among Nonelderly Adults With Hypertension

This study published in the American Journal of Managed Care in May 2014 examined healthcare expenditures among nonelderly adults with hypertension, as compared to patients with other chronic conditions and well patients.  The study found “the prevalence of high total [healthcare expenditure] burdens was significantly greater for persons receiving treatment for hypertension (13.1%) compared with other chronically ill (10.5%) and well patients (5.3%).” These financial burdens to care result in individuals foregoing or delaying care. The study found that “35.2% among the uninsured and 23.9% among those with public coverage said they were unable to get care due to financial reasons.” … Continue reading

The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care

Study: Quality of Care Higher in Medical Homes Compared with Other Practices Physician practices that become patient-centered medical homes can expect to achieve modest improvements in health care quality compared with traditional practices, according to a new Commonwealth Fund–supported study in Annals of Internal Medicine. The researchers, led by Lisa M. Kern, M.D., of Weill Cornell Medical College, compared medical home practices with two types of traditional practices, one using paper records and one using electronic health records (EHRs). All medical homes also have an EHR system. In addition, the study found that the new roles and relationships of providers … Continue reading

Assessing the Potential Impact of the Affordable Care Act on Uninsured Community Health Center Patients: An Update

Geiger Gibson/RCHN Community Health Foundation Research Collaborative Policy Research Brief # 36; Peter Shin, PhD, MPH; Jessica Sharac, MSc, MPH; Sara Rosenbaum, JD   This report provides updated estimates of the number of community health center patients who are expected to gain insurance coverage under health reform. Our original report that estimated the impact of the ACA on uninsured health center patients was based on 2011 Uniform Data System data, while this updated analysis uses 2012 data and includes New Hampshire among the Medicaid expansion states. We estimate that were all states to expand Medicaid, 5.2 million uninsured health center … Continue reading

New Health System Scorecard: States Made Little Progress in Years Prior to ACA

The Commonwealth Fund’s Scorecard on State Health System Performance, 2014, assesses states on 42 indicators of health care access, quality, costs, and outcomes over the 2007–2012 period, which includes the Great Recession and precedes the major coverage expansions of the Affordable Care Act. Changes in health system performance were mixed overall, with states making progress on some indicators while losing ground on others. “This state scorecard underscores the importance of national and state actions to ensure that no matter where a person lives, they have access to an affordable, high-quality health system,” said Commonwealth Fund Senior Vice President Cathy Schoen. … Continue reading

The Journey Towards the Patient-Centered Medical Home: The Kansas City Experience

This report was prepared by Qualis Health to share insights and lessons learned about PCMH development in the safety net setting.  From the report summary: This white paper was prepared to disseminate the learnings from the REACH Healthcare Foundation Medical Home Initiative to the broader health community as primary care practice is redesigned to adopt the patient-centered medical home (PCMH) model of care. It examines the journey of nine safety net primary care clinics in Kansas City as they strive to integrate components of patient-centered care into their daily work. The results are instructive for safety net clinics, collaboratives, and funders.  … Continue reading

New Report: Integration of Oral Health and Primary Care Practice

We are pleased to pass along this email message received today from the Virginia Oral Health Coalition: In response to the need for improved access to oral health care, the Health Resources and Services Administration (HRSA) developed the Integration of Oral Health and Primary Care Practice (IOHPCP) initiative. Coalition staff and board members were invited participants in the stakeholder group which helped develop these recommendations. The resulting IOHPCP report reaffirms the Coalition’s message that oral health is a necessary component of primary care and outlines simple steps for integration, including: Apply oral health core clinical competencies, such as oral health … Continue reading

Structuring Payment to Medical Homes After the Affordable Care Act

This research brief from the Commonwealth Fund summarizes findings and recommendations from a recent study by Harvard Medical School’s Samuel T. Edwards and colleagues as published in the Journal of General Internal Medicine.  Edwards et. al. conclude that patient centered medical homes (PCMHs) and accountable care organizations (ACOs) are complimentary approaches, and the authors recommend specific payment approaches for integrating PCMHs with ACOs. Read the full Brief at the Commonwealth Fund website.

Marketplace Virginia Proposal

The document at this link presents a report from the Senate Finance Subcommittee on Health and Human Resources dated February 16, 2014.  This document contains a description of the Marketplace Virginia proposal.  Please note that this proposal is subject to change as the General Assembly continues its work.