Moran, Katherine J., and Rosanne Burson. “Understanding the Patient-Centered Medical Home”. Home Healthcare Nurse 32.8 (2014): 476-481. Web.
The populations of every country in the world are continuing to grow and in developed countries, the improved quality of living and superior health care available has extended life expectancies far beyond that of the past. A consequence of these developments is a growing number of senior adults requiring medical care in a home setting. According to a study by the American Association of Retired Persons (AARP), almost 92 percent of the participants stated they wanted to remain in their homes as long as they physically were able and continue to participate in community activities (Senior Housing News). In terms of economics, intermittent health care provided by visiting nurses and nursing assistants in the home allowed the beds in nursing homes to remain available for the patients in more critical conditions.
It has been realized that the traditional care offering to seniors remaining in their home must be evaluated in terms of integrated patient care in order to address the often complex treatments required. The patient-centered medical home (PCMH) provides primary care through the combined efforts of patients, their families, doctors, and other members of the home healthcare team (Zajac, Norris and Keenum). The goal of PCMH is to create strong relationships with patients and provide health care in the home that is affordable, accessible, and high-quality consistent with standard of the Patient Protection and Affordable Care Ace of 2010 (Rittenhouse and Shortell).
Improvement in home health care has the ability to meet and exceed the standard set with advances in technology for tracking of patients, tests, and referrals. In addition, electronic prescribing, care management, performance reports, and other forms of communication lend support to keeping senior patients in their home with adequate health care. Each patient is assigned a primary care provider who coordinates the staff. The use of evidence-based medical decisions promotes better patient connection and allows additional payment for the provider. Until lately, payment methods have given providers little motivation to improve care quality. Pay-for-performance programs address the need for management of chronic diseases in the elderly and the success of the PCMH model is dependent on reimbursement by health plans.
Research has shown that when care provided in home settings by the primary doctors is satisfactory, there are less uses of the emergency room, less hospital admissions, better compliance by the patient with doctor recommendation, better health results, and less spending by Medicare (Nielsen et al.). Beyond patient satisfaction and decreased spending, another benefit to the PCMH model is less possibility of burnout on the part of healthcare providers and increased satisfaction with their jobs. For these three reasons, the approach is recommended by the American Academy of Family Physicians, the American College of Physicians, and the American Academy of Pediatrics (Association of American Medical Colleges).
Caution is needed to support an infrastructure that uses technology to link health information, community organization, support of self-management, and communication between health care team members. Continuous monitoring for efficiencies and results is needed, but the outlook for the future of patient-centered medical homes is optimistic.
Works Cited
Association of American Medical Colleges. (2008). The medical home: Position statement. Web.
Moran, Katherine J., and Rosanne Burson. “Understanding The Patient-Centered Medical
Home”. Home Healthcare Nurse 32.8 (2014): 476-481. Web.
Nielsen, M. et al. Benefits of Implementing The Primary Care Patient-Centered Medical Home:
A Review Of Cost & Quality Results. Milbank Memorial Fund, 2012. Web. 20 June 2015.
Patient-Centered Primary Care Collaborative.
Rittenhouse, Diane R., and Stephen M. Shortell. “The Patient-Centered Medical Home”. JAMA
301.19 (2009): 2038. Web. 20 June 2015.
Senior Housing News. “AARP Study: Seniors Want To Stay At Home, Local - Senior Housing
News”. N.p., 2010. Web. 20 June 2015.
Zajac, P., M.C. Norris, and A.J. Keenum. “The Patient-Centered Medical Home.”. Osteopathic
Family Medicine (2014): n. pag. Web.
