Lisa M. Kern, Rina V. Dhopeshwarkar, Alison Edwards, and Rainu Kaushal
L. M. Kern, R. V. Dhopeshwarkar, A. Edwards et al., "Patient Experience Over Time in Patient-Centered Medical Homes," American Journal of Managed Care, May 2013 19(5):403–10.
The patient-centered medical home (PCMH) is being implemented in primary care practices across the United States, but there is little understanding of whether this care delivery model actually improves patients' experiences―one of its explicit goals. Commonwealth Fund–supported researchers sought to measure patients’ experiences over time in practices that have adopted the PCMH model.
To establish a baseline, researchers first surveyed patients receiving care from 120 primary care providers at 10 different practices at the time the practices had just received PCMH recognition by the National Committee for Quality Assurance, an accrediting organization. A second survey was fielded approximately 15 months later. In all, 715 patients were surveyed, all using the scientifically validated Consumer Assessment of Healthcare Providers and Systems.
The researchers found significant improvement in ratings of access to care, with 61 percent of patients giving the highest rating at baseline and 69 percent at follow-up. There were no other significant changes over time in the other six domains of patient experience.
The workflow modifications used to improve access to care may have had more rapid effects on patients' experiences than other changes, the authors note. What's more, patients were least satisfied with access when initially surveyed, leaving the most room for improvement in this domain. The study is one of the first to find that medical homes affect patient experiences in a community with multiple payers, fee-for-service reimbursement, and locally driven improvement.