Largest Physician Group Practices Most Likely to Adopt Medical Home Model

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<p>The patient-centered medical home model is by now widely recognized as a promising approach to delivering comprehensive care and ensuring the best outcomes for patients. In the new issue of <em>Health Affairs,</em> two Commonwealth Fund-supported articles explore the extent to which large physician practices have adopted the model and how broad adoption might be able to address a number of problems plaguing our health care system.<br><br>In the first article, <a href="/publications/in-the-literature/2008/sep/measuring-the-medical-home-infrastructure-in-large-medical-groups
">Measuring the Medical Home Infrastructure in Large Medical Groups</a>, researchers led by Diane Rittenhouse, M.D., M.P.H., at the UCSF School of Medicine report that in general, medical groups have been slow to adopt components of the patient-centered medical home. The largest practices in the study--those with more than 140 physicians--and those owned by a hospital or HMO scored highest on critical measures of the medical home model.<br><br>The study, which was supported by the Robert Wood Johnson Foundation, the Commonwealth Fund, and the California HealthCare Foundation, surveyed all large physician practices across the U.S. that treat patients with asthma, diabetes, congestive heart failure, and depression. They looked at four measures of medical homes, including the use of care teams, the degree of care coordination and integration, including the use of electronic health records; efforts undertaken to maximize quality and safety; and the provision of "enhanced access" to care, such as consultation by e-mail.<br><br>"The medical home model holds great promise for the transformation of primary care, but this transformation won't happen overnight," said Rittenhouse.<br><br>In the second <em>Health Affairs</em> article, <a href="/publications/in-the-literature/2008/sep/a-house-is-not-a-home--keeping-patients-at-the-center-of-practice-redesign
">A House Is Not a Home: Keeping Patients at the Center of Practice Redesign</a>, a team led by the Urban Institute's Robert Berenson, M.D., identifies ways in which medical homes could address problems facing the health care system and discusses prerequisites for medical home implementation.<br><br>Implementing and operating patient-centered medical homes require management capability and physician leadership, as well as the capacity to develop processes and information technology systems, the authors note. These conditions, they say, will present challenges for any practice, regardless of size.</p>