"We've been together since way back when,
And sometimes I never want to see you again.
But I want you to know, after all these years,
That you're still the one …"
Nine years ago this month, the American Academy of Family Physicians collaborated with the American College of Physicians, American Academy of Pediatrics, and the American Osteopathic Association to develop and introduce the Joint Principles of the Patient-Centered Medical Home (PCMH). These principles were viewed as the articulation of ideas that would establish a health care system that was focused on the patient, foundational in primary care, and mindful of appropriate use of our limited health care resources.
Since February 2007, the Joint Principles have been foundational in establishing a variety of advanced primary care delivery models in public and private health care systems and remain the most applicable and appropriate roadmap for primary care delivery system reforms. Today, the PCMH, or some variation of the concept, is recognized by every major private insurer, Medicare, Medicaid, the Veterans Health Administration, and the Department of Defense. And, most importantly, it is the only delivery system model mentioned and recognized in the recently enacted and soon to be implemented Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
So after nine years, the question we all should be asking ourselves is: "Do advanced primary care practices built on the principles of the PCMH improve quality and reduce the cost of health care?"
For the answer, I point you to a report recently released by the Patient-Centered Primary Care Collaborative (PCPCC) entitled the "Patient-Centered Medical Home's Impact on Cost & Quality: Annual Review of Evidence 2014-2015." The PCPCC report looked at 30 published studies of advanced primary care or medical home practices and or programs. Seventeen of these studies were peer-reviewed, four were state government evaluations, six were industry reports, and three were independent evaluations of federal initiatives. Based on this report, I would suggest that the answer to the question above is yes, but let's take a look at the key findings from the report's executive summary:
Each of you has a rich understanding of just how impactful comprehensive, continuous, and connected primary care can be. You live it each day. This report and others that have been published during the past few years are starting to demonstrate, in a quantifiable manner, the true value of primary care.
I had three other important takeaways from the PCPCC report:
It has not been an easy ride, but the AAFP remains strongly supportive of the Joint Principles. They remain as needed and applicable today as they did when they were created. There is work to do, of course. However, there is growing evidence that advanced primary care practices, when supported by systemic changes in payments, improve quality and decrease the overall cost of health care. That's why, as the song lyric states, PCMH is "still the one."
Public Health Alert: Zika
Many of you have likely been following the Zika virus issue. The AAFP has as well. My colleagues in the AAFP's Division of Health of the Public and Science have been working diligently to assemble information and resources for you and your practice. I encourage you to use these excellent resources and share them with your colleagues. As a family physician you play an important role in public health outbreaks such as this and we urge you to be prepared to assist your patients and your community.
In addition to the AAFP's resources, you may find Zika related resources at the following sites:
Stephanie Quinn, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy. Read author bio »