Consumer-Purchaser Disclosure ProjectConsumer-Purchaser Disclosure ProjectThe Patient Centered Medical HomeThe Patient Centered Medical Home

A New Model for Primary and Principal CareA New Model for Primary and Principal Care Washington, DCWashington, DC

October 17, 2007October 17, 2007

John Tooker MD,MBA,FACPChief Executive Officer/EVP

American College of Physicians

The Patient Centered Medical HomeThe Patient Centered Medical HomeScope of PresentationScope of Presentation

Rationale for the modelRationale for the model

Description of the modelDescription of the model

Building consensusBuilding consensus

The question we asked :

Is there a better way to organize and finance care by primary and principal care

physicians that will lead to better outcomes, lower costs, and

increased interest in general IM?

PatientsPatients

Awash in Information, Patients Face a Lonely, Uncertain Road

August 14, 2005 ( HOFFMAN,J)

Sick and Scared, and Waiting, Waiting, Waiting

August 20, 2005 (KOLATA)

55 % of adults surveyed said they were dissatisfied with the quality of their health care, up from 44 percent in 2000; and 40 percent said the quality of care had gotten worse in the last five years.Harvard University, AHRQ and the Kaiser Family Foundation

(2004)

How Many Doctors Does It Take to Treat a Patient?

June 27, 2007 (BACH)

Informed,ActivatedPatient

ProductiveInteractions

Prepared,ProactivePractice Team

DeliverySystemDesign

DecisionSupport

ClinicalInformation

Systems

Self-Management

Support

Health System

Resources and Policies

Community

Health Care Organization

Wagner Care Model

Improved Outcomes

Of a Like MindOf a Like Mind

We found that other primary care groups—We found that other primary care groups—AAFP, AAP, and AOA—have policies that AAFP, AAP, and AOA—have policies that support physician-guided, patient-support physician-guided, patient-centered care through a “medical home”centered care through a “medical home”

AAFP, AOA, AAP and ACP joint principles AAFP, AOA, AAP and ACP joint principles incorporate the thinking of all four incorporate the thinking of all four organizations into the “patient centered organizations into the “patient centered medical home” (PCMH)medical home” (PCMH)

Joint Principles of the PCMHJoint Principles of the PCMHAAP, AAFP, ACP, AOA AAP, AAFP, ACP, AOA March 2007March 2007

Whole person orientationWhole person orientation

Personal physicianPersonal physician

Physician directed medical practicePhysician directed medical practice

Care is coordinatedCare is coordinated and/or integratedand/or integrated

Quality and safetyQuality and safety

Enhanced accessEnhanced access to care to care

Payment to support the PC-MHPayment to support the PC-MH

Building ConsensusBuilding Consensus

AAFP, AAP, ACP, AOA – “Joint Principles” March 2007AAFP, AAP, ACP, AOA – “Joint Principles” March 2007

NCQA PPC PCMH qualification - July 2007NCQA PPC PCMH qualification - July 2007

Patient Centered Primary Care Collaborative Principles (PCPCC) May Patient Centered Primary Care Collaborative Principles (PCPCC) May 20072007

ERICERIC

ConsumersConsumers

Health plans (September 2007)Health plans (September 2007)

PhysiciansPhysicians

QI organizationsQI organizations

Current EventsCurrent Events

Proving the concept – demosProving the concept – demos

Private sectorPrivate sector

UnitedUnited

PCPCC multi-player PCPCC multi-player (plans and employers)(plans and employers)

Medicare demoMedicare demo

Medicaid projectsMedicaid projects

Costing the medical home Costing the medical home project project

PCPCC summit – November 7thPCPCC summit – November 7th