Harvard Health Letter

New year, new approach to health care

Patient-centered medical homes are improving your care by focusing on prevention and teamwork.

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The team at a patient-centered medical home develops a long-term treatment plan for you. It focuses on prevention, education, and coordinated care.

A transformation is taking place in family medicine practices across the country: they're switching to a team-based model of care called a patient-centered medical home (PCMH). "It's the highest and best version of primary care, specifically designed to take care of people's preventive needs as well as complex chronic conditions," says Susan Edgman-Levitan, executive director of the John D. Stoeckle Center for Primary Care Innovation at Harvard-affiliated Massachusetts General Hospital.

How it works

The PCMH turns a doctor's practice into a physician-led team that makes a point to get to know you, develop a long-term treatment plan for you, focus on prevention, educate you about your health goals, and coordinate care with other specialists if necessary to help you meet your goals. The team must be available to you, at least by telephone, 24 hours a day, seven days a week.

Holding the team accountable to these high standards are several national accreditation programs that provide certifications and keep track of a PCMH's progress.

Why it's happening

The PCMH concept was introduced by the American Academy of Pediatrics in the 1960s and took off in the late 2000s among family practice and internal medicine doctors. Since then, thousands of doctor's offices have made the switch.

What's driving it? "Employers, because they know this model provides high-quality and efficient care, and reduces care people don't need," says Edgman-Levitan. "Also doctors, who know it decreases burnout among physicians and staff. They've now got a team of people helping them do their job better."

Because of the potential to save medical costs through prevention, insurance companies and state and federal programs are providing financial incentives for practices to switch to a PCMH structure. According to the National Academy for State Health Policy, more than 43 states have adopted policies and programs to promote this approach to health care.

Benefits for you

As its name implies, the PCMH makes you the focus, with the goal of making you more comfortable with your team and more likely to stick to your treatment plan. If you're taking a preventive approach to your care, you'll stay healthier, which can save money and improve your quality of life. And you'll receive better treatment as well, with team members following up to find out if you've stuck with your medication regimen, gotten a scheduled screening, or kept an appointment with a specialist. "Care improves over time because the PCMH must document what it's doing to improve care," says Edgman-Levitan. "For example, practices have to document how they track phone calls from patients and when they respond."

Questions to ask

If your doctor's office makes the switch to a PCMH, you'll want to ask key questions such as these:

  • Who's on your care team?

  • What are their roles?

  • How will this change your access to care?

  • Will it mean longer office hours?

  • How often will you have regular appointments?

  • When will your team develop a care plan for you?

  • Does the PCMH use a patient portal?

A patient portal enables you to look up your test results and medical records, ask for prescription refills, and send questions to the nurses and doctors.

Because the PCMH includes you in creating a treatment plan, you should also find out how you can be a good team player. "Will the PCMH staff provide educational resources to help you do a better job of managing your health care? Find out how they'll follow up with you," says Edgman-Levitan.

She also encourages you to speak up and take part. "Come with questions. Write them down in advance. Ask if your practice is looking for patient advisers to help work on quality improvements. You're going to have a voice when it comes to what's happening in the practice and whether it's meeting your needs, and it will benefit you to take advantage of it."