February Month in Review: Unlocking the PCMH Evidence

Dear Members and Friends,

Thanks to the co-chairs of the bipartisan Congressional Primary Care Caucus – Rep. Joe Courtney (D-CT) and Rep. David Rouzer (R-NC), pictured at left – for helping us launch our latest PCMH evidence report, "The Patient-Centered Medical Home's Impact on Cost and Quality: Annual Review of Evidence, 2014-2015." Details on the report and the 30 PCMH studies within it can be found here.

Here are the key findings to help guide our collective future efforts:

• PCMH controls costs by providing the right care: Positive, consistent trends show that advanced primary care improves quality and helps decrease costs. By providing the right primary care “upstream,” we can make a positive impact on how care is used “downstream” such as decreased emergency department (ED) visits and avoidable hospitalizations. Up next: consistent assessment of total cost of care that simultaneously measures better care, better health, and clinician satisfaction.
• Payment and performance BOTH must be aligned: Payment reform is necessary but not sufficient for clinician buy-in. Alignment of performance measures across payers is critical too. The most impressive cost and utilization outcomes came from multi-payer collaboratives that aligned payment and incentivized performance measures linked to quality, utilization, patient engagement and/or cost savings. No single payment model best supported the PCMH, but moving away from fee-for-service is a must. Up next: implementation of Medicare payment reform through MACRA. 
• Assessing and promoting the value of PCMH is needed: Significant variation in PCMH initiatives/programs makes for challenging evaluations and expectations. Up next: measurement and recognition of PCMHs must be better aligned with value as defined by patients, providers, and payers.

Thanks too to impressive state leaders from Colorado who are demonstrating how multi-payer collaboratives drive change. Bert Miuccio, CEO of HealthTeamWorks, and to Vatsala Parthy, Director of Colorado’s State Innovation Model (SIM) and Practice Transformation Network (PTN), shared their valuable insight during our February monthly executive member briefing – providing the “inside scoop” from one of the nation’s leading states in multi-payer PCMH innovations. If your organization is not currently an executive member, we’d love to have you on board. For more information, please reach out to Amanda Holt on our team (amanda@pcpcc.org).

Lots of news to share below – and thanking each of you for your continued support to primary care, our primary cause!