According to an 18-month study from researchers at the University of Connecticut (UConn) and EmblemHealth, a New York-based health insurance company, small practices can make an easier transition to patient-centered medical home (PCMH) status when they are provided with external support. The study, which defines a small practice as 10 or less physicians, says this support includes practice redesign, care management, and payment reform.
The study, called “A Randomized, Controlled Trial of Implementing the Patient-Centered Medical Home Model in Solo and Small Practices," says that without such support systems, change is slow and limited in scope. According to the study's authors, most primary care practices in the US are of small or medium size, and not part of an integrated health system.
The authors of the study looked at 18 practices for an intervention group and 14 practices for a control group. The study showed that small practices receiving intervention support improved significantly on eight of the nine National Committee for Quality Assurance (NCQA) standards for Medical Homes. Whereas 44 percent of the control physician practices accrued any points toward NCQA standards, 100 percent of the intervention practices accrued PCMH points.
After the 18-months were finished, 80 percent of the intervention group practices achieved Level 3 NCQA Patient-Centered Medical Home recognition, the highest designation, an additional five percent achieved Level 2 status, and 10 percent were at Level 1.
The study's findings are published in the Sept. 2012 in the Journal of General Internal Medicine.
