Patient-Centered Medical Home (PCMH)

With greater policy certainty assured by the Supreme Court’s affirmation of the constitutionality of healthcare reform this summer, industry pioneers are beginning to shape the new healthcare, and moving forward on a broad range of population health-based concepts. The strategic challenges—and opportunities—for healthcare IT leaders can’t be overstated.

I think Henry Ford articulated it best when he said, "Failure is only the opportunity to begin again, only this time more wisely." We all learn from our mistakes, and I think one area rife with redos and re-tinkering of strategies is the health information exchange (HIE) market.

After a win with the Atlantic City Special Care Center, the Cambridge Mass.-based Iora Health is replicating its care model of intensive primary care management services, aligned incentives, and actionable analytics, across the country. Iora Health's guiding principle is to target the small group of patients who generate the most healthcare costs, and treat them using a global budget, rather than fee-for-service infrastructure.

This week was a big one for healthcare in my home state of Massachusetts. Along with announcing the creation of a statewide HIE from CMS funds (making them the first state in the nation to receive federal funding participation approval through CMS to create a HIE), lawmakers from the Commonwealth of Massachusetts passed another landmark bill. Appropriately named the Health Care Cost Control Bill (HCCB), it has a goal of cutting healthcare costs by $200 billion by 2028 by implementing a spending limit.

At the Healthcare Financial Management Association ANI annual conference last month in Las Vegas, I heard a presentation by Randall Gehle, D.O., about his involvement with helping his medical group make the transition to the patient-centered medical home (PCMH) model. He described the transition process, some of its challenges, and how it has had an impact on his family medicine practice.