Public, Private Help Smooth Transition to Medical Home

For some primary care physicians, the idea of transforming a practice into a medical home sounds like a major risk.

Yet practices that have made the change in states such as Rhode Island have reported smooth transitions, thanks in part to financial and technical support from public and private entities. By hiring a care manager and training existing staff to take on additional care tasks, the model can succeed, these physicians say.

Family physician Gregory Steinmetz, M.D., left, Julie Rousseau, F.N.P.C., and Martin Kerzer, D.O., review patient information at the Associates in Primary Care Medicine office in Warwick, R.I. The three are part of the practice's medical home team.

Nearly half of all states have made patient-centered medical homes a priority, thanks in large part to state funding and cooperation among private insurers. As of June of last year, 18 states were participating in multipayer medical home initiatives, and five others were planning similar efforts, according to an October 2014 report( by the National Academy for State Health Policy.

In Rhode Island, where the state mandates that insurance companies devote 10 percent of spending to primary care, the Rhode Island Chronic Care Sustainability Initiative( (CSI-RI) is one model for making a transition from a traditional fee-for-service practice to the patient-centered medical home (PCMH). The initiative began in 2008 as a pilot project involving just five practice sites and is slated to become a nonprofit with a new name, the Care Transformation Collaborative of Rhode Island, in June.

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