Many people in Maryland today are asking for a new kind of relationship with their primary care provider. They want someone who can serve as a trusted advisor who will treat the whole person while delivering more patient-centered care. After all, primary care is the foundation of high-performing health systems.
Maryland is at the epicenter of a powerful new concept in patient care that is garnering attention from Washington D.C. and across the country — the "Patient Centered Medical Home" (PCMH). The PCMH model is simple in that it centers on a patient's total care, starting with wellness, the prevention of illness, and enhanced access to care through extended office hours, and telephone and e-mail communication, by a single caregiver — a primary care provider. As co-chair of the Maryland Health Quality and Cost Council, Lt. Gov. Anthony G. Brown brought stakeholders from various sectors together to help make this kind of care part of the health care agenda in Maryland.
In this system, primary care providers are better able to help manage all their patient's health needs and coordinate care with other health professionals using a team approach. Research clearly shows that a patient-centered home approach is good for both people's health and for their pocketbooks.
Positive results have been realized in preventing disease, in assisting patients to better navigate a complex health system, and in helping patients manage their chronic conditions. For example, improved management of pre-existing asthma conditions has allowed patients to avert asthmatic attacks and therefore reduce their trips to the emergency room. Studies show that the medical home model can reduce emergency room visits by as much as 50 percent and can contribute to a 40 percent reduction in hospitalizations for individuals with chronic illnesses.
This focus on paying providers for providing "good care" versus the number of patients they see is a critical step in promoting wellness across the country. The PCMH model adds an additional payment to providers for offering these extra services and offers them an opportunity to share in cost savings while meeting quality standards.
Maryland took a critical step in adopting this model with the General Assembly's recent enactment of the Patient Centered Medical Home (PCMH) Program. Overseen by the Maryland Health Care Commission, the new program initially involves 50 practices, 200 primary care providers and some 200,000 Marylanders. Practices will apply to participate in the fall and will start providing services in January.
In fact, some practices are already leading the way, including a nine-practice pilot established in Maryland in 2009 by CareFirst. Under the leadership of Dr. Carol Reynolds, the White Marsh Medical Center of Potomac Physicians was the first in Maryland to achieve the highest level of recognition available under the Patient Centered Medical Home program.
Primary care providers need to take the time to learn about this new program taking hold throughout the state, and patients need to make their voices heard. Let your primary caregiver know that this is the kind of care you would like for yourself and for your family.
As patient-centered medical homes increase, we will move to a common model for the coordination of care, advancements in the use of electronic medical records and a standard measure for success based on keeping patients healthier. Employers will also play a critical role in providing incentives for employees to work with their primary care providers to stay well and in designing their insurance coverage to support patient-centered medical homes.
With this year's signing of the federal health care reform bill, the Patient Protection and Affordable Care Act, Congress took strong steps to re-emphasize primary care delivery. The act provides funds for a number of primary care-focused projects, such as the Patient Centered Medical Home, that are designed to improve care while reducing costs.
Maryland's passage of the Patient Centered Medical Home Program has given us a head start in getting a handle on growing medical costs with a smarter approach to health care.
Dion Rudnicki is senior location executive for Bethesda for IBM, one of the nation's largest purchasers of health care and a company that is involved in helping Maryland recruit primary care providers for the Patient Centered Medical Home initiative. His e-mail is rudnicki@us.ibm.com.