7 Ways Hospitals Can Support the Medical Home Model

Tuesday, January 11th, 2011
This post was written by Patricia Donovan

Hospitals can participate in the patient-centered medical home (PCMH) by supporting primary care practices in seven key areas, according to a September 2010 American Hospital Association report.:

  • Convene physicians: Hospitals may be able to bring together affiliated physicians to further develop the strong relationships necessary for a successful PCMH. For instance, primary care providers in a PCMH will need to track patients to ensure they follow up with specialists (Fields, 2010). Currently, no incentives exist for specialists to work collaboratively with primary care providers in a PCMH. Hospitals may be able to able to link PCMH initiatives with their affiliated specialists. This arrangement also provides a platform for implementing an ACO.

  • Offer capital and IT infrastructure: Hospitals may be able to play a critical role in new PCMH models by offering information technology networks and capital resources to primary care providers. Currently, few local, independent physician practices and local community centers have the IT capabilities to seamlessly communicate with local hospitals. Hospitals considering participation in a PCMH should consider the substantial resources to be invested in IT capabilities (Deloitte, 2008) and analyze whether they will be able to offer those resources to the newly formed PCMH and their prospective partners.

  • Offer staff resources and other functionalities: Hospitals may also be able to support PCMHs with staff resources and other functionalities. Most of the members of the ‗health teams‘ described in health reform, such as medical specialists, nurses, pharmacists, nutritionists, dieticians, social workers, health educators/health system navigators, behavioral, and mental health providers are all resources that hospitals may already have in-house. Hospitals may be able to leverage these staff resources in a PCMH. It is also conceivable that hospitalists, in their role as care managers for hospitalized patients and those responsible for returning patients to their primary physicians at discharge, could have a role to play in care coordination in the PCMH model.

  • Offer management expertise: Many primary care providers may not possess the management or knowledge translation expertise required to effectively administer a PCMH initiative. Hospitals may be able to lend administrative expertise to PCMH initiatives to further these goals.

  • Serve as an administrator of bundled payment: Hospitals are able to use their management capacity and organizational structure to develop payment allocation methods for components of the payment bundle that are the responsibilities of primary care, specialists, hospital inpatient and outpatient units, and related facilities. An important function of the bundled payment administrator is to assume overall accountability for the financial and clinical integration of patient care; a potential role that hospital management is well positioned to assume.
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