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https://www.readbyqxmd.com/read/29767402/connecting-refugees-to-medical-homes-through-multi-sector-collaboration
#1
Lemaat Michael, Alexandra K Brady, Greg Russell, Scott D Rhodes, Shahla Namak, Laura Cody, Andrea Vasquez, Andrea Caldwell, Jennifer Foy, Julie M Linton
As increasing numbers of refugees have resettled globally, an interdisciplinary group of stakeholders in Forsyth, North Carolina, recognized obstacles preventing coordinated medical care, which inspired the development of our Refugee Health Collaborative. This study assessed the Collaborative's impact on access to coordinated care within patient-centered medical homes (PCMH). A Collaborative-developed novel algorithm guided the process by which refugees establish care in PCMHs. All refugees who established medical care in the two primary health systems in our county (nā€‰=ā€‰285) were included...
May 16, 2018: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/29763409/the-patient-centered-medical-home-expensive-and-in-need-of-repair
#2
Peter Boland
On the one hand, the PCMH is an admirable effort to gather in one place all the disparate and disorganized clinical and social supports the patient needs. At the same time, though, medical homes employ provider-defined business models and conventional performance measures, belying the patient-centered in the name.
May 2018: Managed Care
https://www.readbyqxmd.com/read/29759058/impact-of-medical-homes-on-expenditures-and-utilization-for-beneficiaries-with-behavioral-health-conditions
#3
Melissa A Romaire, Vincent Keyes, William J Parish, Konny Kim
OBJECTIVE: Individuals with behavioral health conditions may benefit from enhanced care management provided by a patient-centered medical home (PCMH). In late 2011 and early 2012 Medicare began participating in PCMH initiatives in eight states through the Multi-Payer Advanced Primary Care Practice (MAPCP) demonstration. This study examined how the initiatives addressed the needs of patients with behavioral health conditions and the impacts of the demonstration on expenditures and utilization for this population...
May 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29743228/implementation-of-the-geriatric-patient-aligned-care-team-model-in-the-veterans-health-administration-va
#4
Jennifer L Sullivan, Rina Eisenstein, Thomas Price, Samantha Solimeo, Kenneth Shay
BACKGROUND: Here, we describe the implementation of a specialty primary care medical home (PCMH) model called Geriatric Patient-Aligned Care Teams (GeriPACT) in the Veterans' Health Administration (VA) that is focused on serving older complex patients. In particular, our aims in this article are to describe how the GeriPACT model was developed and implemented in VA sites, provide a closer look at how GeriPACT functions by presenting a case study, and highlight data showing national variation in the implementation of GeriPACT staffing models and PCMH practices...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29732687/patient-centred-medical-home-pcmh-and-patient-practitioner-orientation-is-there-a-relationship
#5
Shamima Khan, Harlan E Spotts, Peter C Lindblad, Joshua J Spooner
BACKGROUND: The patient-centred medical home (PCMH) and utilisation of a patient-centred care approach have been promoted as opportunities to improve healthcare quality while controlling expenditures. OBJECTIVES: To determine the penetration of PCMH within physician practices, and to evaluate physician attitudes towards patient-practitioner orientation. The ultimate objective was to explore relationships between the patient-practitioner orientation of respondents and the presence of PCMH elements within their practice...
May 6, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29683867/communication-among-team-members-within-the-patient-centered-medical-home-and-patient-satisfaction-with-providers-the-mediating-role-of-patient-provider-communication
#6
Susan E Stockdale, Danielle Rose, Jill E Darling, Lisa S Meredith, Christian D Helfrich, Timothy R Dresselhaus, Philip Roos, Lisa V Rubenstein
BACKGROUND: The Patient-centered Medical Home (PCMH) uses team-based care to improve patient outcomes, including satisfaction. The quality of patients' communication with their primary care providers (PCPs) is a key determinant of patient satisfaction. A shift to team-based care could disrupt the therapeutic relationship between patients and their PCPs and reduce patient satisfaction if communication and coordination among primary care team members is poor. Little is known about the relationship between intrateam communication within a PCMH and patient satisfaction with PCPs, and whether patient-provider communication might mediate this relationship...
June 2018: Medical Care
https://www.readbyqxmd.com/read/29673900/the-economics-of-patient-centered-care
#7
Guy David, Philip A Saynisch, Aaron Smith-McLallen
The Patient-Centered Medical Home (PCMH) is a widely-implemented model for improving primary care, emphasizing care coordination, information technology, and process improvements. However, its treatment as an undifferentiated intervention in policy evaluation obscures meaningful variation in implementation. This heterogeneity leads to contracting inefficiencies between insurers and practices and may account for mixed evidence on its success. Using a novel dataset we group practices into meaningful implementation clusters and then link these clusters with detailed patient claims data...
March 27, 2018: Journal of Health Economics
https://www.readbyqxmd.com/read/29629923/organizational-processes-and-patient-experiences-in-the-patient-centered-medical-home
#8
Jaya Aysola, Marilyn M Schapira, Hairong Huo, Rachel M Werner
BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. RESEARCH DESIGN: We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system...
April 6, 2018: Medical Care
https://www.readbyqxmd.com/read/29626635/on-the-origin-of-vanillyl-alcohol-oxidases
#9
Gudrun Gygli, Ronald P de Vries, Willem J H van Berkel
Vanillyl alcohol oxidase (VAO) is a fungal flavoenzyme that converts a wide range of para-substituted phenols. The products of these conversions, e.g. vanillin, coniferyl alcohol and chiral aryl alcohols, are of interest for several industries. VAO is the only known fungal member of the 4-phenol oxidising (4PO) subgroup of the VAO/PCMH flavoprotein family. While the enzyme has been biochemically characterised in great detail, little is known about its physiological role and distribution in fungi. We have identified and analysed novel, fungal candidate VAOs and found them to be mostly present in Pezizomycotina and Agaricomycotina...
April 4, 2018: Fungal Genetics and Biology: FG & B
https://www.readbyqxmd.com/read/29611089/impact-of-patient-centered-medical-home-implementation-on-diabetes-control-in-the-veterans-health-administration
#10
LeChauncy D Woodard, Omolola E Adepoju, Amber B Amspoker, Salim S Virani, David J Ramsey, Laura A Petersen, Lindsey A Jones, Lea Kiefer, Praveen Mehta, Aanand D Naik
BACKGROUND: Given its widespread dissemination across primary care, the Veterans Health Administration (VA) is an ideal setting to examine the impact of the patient-centered medical home (PCMH) on diabetes outcomes. OBJECTIVE: To assess the impact of PCMH implementation on diabetes outcomes among patients receiving care in the Veterans Health Administration. DESIGN: Retrospective cohort analysis and multilevel logistic regression. PATIENTS: Twenty thousand eight hundred fifty-eight patients in one Midwest VA network who had a diabetes diagnosis in both 2009 and 2012 and who received primary care between October 1, 2008 and September 30, 2009...
April 2, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29578853/michigan-pharmacists-transforming-care-and-quality-developing-a-statewide-collaborative-of-physician-organizations-and-pharmacists-to-improve-quality-of-care-and-reduce-costs
#11
Hae Mi Choe, Alexandra Tungol Lin, Kathleen Kobernik, Marc Cohen, Laurie Wesolowicz, Nabeel Qureshi, Tom Leyden, David A Share, Rozanne Darland, David A Spahlinger
BACKGROUND: Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. PROGRAM DESCRIPTION: Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan...
April 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29553281/assessing-medical-home-mechanisms-certification-asthma-education-and-outcomes
#12
Nathan D Shippee, Michael Finch, Douglas R Wholey
OBJECTIVES: Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process)...
March 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29535239/barriers-and-facilitators-to-expanding-roles-of-medical-assistants-in-patient-centered-medical-homes-pcmhs
#13
Jeanne M Ferrante, Eric K Shaw, Jennifer E Bayly, Jenna Howard, M Nell Quest, Elizabeth C Clark, Connie Pascal
BACKGROUND: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes. METHODS: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29533272/team-functioning-as-a-predictor-of-patient-outcomes-in-early-medical-home-implementation
#14
Frances M Wu, Lisa V Rubenstein, Jean Yoon
BACKGROUND: New models of patient-centered primary care such as the patient-centered medical home (PCMH) depend on high levels of interdisciplinary primary care team functioning to achieve improved outcomes. A few studies have qualitatively assessed barriers and facilitators to optimal team functioning; however, we know of no prior study that assesses PCMH team functioning in relationship to patient health outcomes. PURPOSE: The aim of the study was to assess the relationships between primary care team functioning, patients' use of acute care, and mortality...
March 12, 2018: Health Care Management Review
https://www.readbyqxmd.com/read/29452920/patient-centered-medical-homes-did-not-improve-access-to-timely-follow-up-after-ed-visit
#15
Shih-Chuan Chou, Craig Rothenberg, Alicia Agnoli, Ilse Wiechers, Jason Lott, Jennifer Voorhees, Steven L Bernstein, Arjun K Venkatesh
BACKGROUND: Patients newly insured through coverage expansion under the Affordable Care Act (ACA) may have difficulty obtaining timely primary care follow-up appointments after emergency department (ED) discharge. We evaluated the association between availability of timely follow-up appointment with practice access improvements, including patient-centered medical home (PCMH) designations or extended-hours appointments. METHODS: We performed a secret-shopper audit of primary care practices in greater New Haven, Connecticut...
May 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29451116/population-tailored-care-for-homeless-veterans-and-acute-care-use-cost-and-satisfaction-a-prospective-quasi-experimental-trial
#16
Thomas P O'Toole, Erin E Johnson, Matthew Borgia, Amy Noack, Jean Yoon, Elizabeth Gehlert, Jeanie Lo
INTRODUCTION: Although traditional patient-centered medical homes (PCMHs) are effective for patients with complex needs, it is unclear whether homeless-tailored PCMHs work better for homeless veterans. We examined the impact of enrollment in a Veterans Health Administration (VHA) homeless-tailored PCMH on health services use, cost, and satisfaction compared with enrollment in a traditional, nontailored PCMH. METHODS: We conducted a prospective, multicenter, quasi-experimental, single-blinded study at 2 VHA medical centers to assess health services use, cost, and satisfaction during 12 months among 2 groups of homeless veterans: 1) veterans receiving VHA homeless-tailored primary care (Homeless-Patient Aligned Care Team [H-PACT]) and 2) veterans receiving traditional primary care services (PACT)...
February 15, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29432080/team-based-care-views-from-community-health-center-staff
#17
Kristi L Law, Jeannine M Rowe
Community health centers (CHC) provide quality care for vulnerable patients, and a potentially contributing factor to this quality is the integration of a patient-centered medical home (PCMH). PCMH relies on a team-based approach, a principle in which social workers are trained and research examines in primary care environments. Less is known about team-based care in CHCs. An exploratory qualitative study with 14 CHC staff was conducted to examine the current state of team-based care and secondarily, to examine the role of social workers...
April 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29404947/characteristics-of-patient-centered-medical-home-initiatives-that-generated-savings-for-medicare-a-qualitative-multi-case-analysis
#18
Rachel A Burton, Nicole M Lallemand, Rebecca A Peters, Stephen Zuckerman
BACKGROUND: Through the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, Medicare, Medicaid, and private payers offered supplemental payments to 849 primary care practices that became patient-centered medical homes (PCMHs) in eight states; practices also received technical assistance and data reports. Average Medicare payments were capped at $10 per beneficiary per month in each state. OBJECTIVE: Since there was variation in the eight participating states' demonstration designs, experiences, and outcomes, we conducted a qualitative multi-case analysis to identify the key factors that differentiated states that were estimated to have generated net savings for Medicare from states that did not...
February 5, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29311170/integrating-community-health-workers-into-medical-homes
#19
Elizabeth A Rogers, Sarah Turcotte Manser, Joan Cleary, Anne M Joseph, Eileen M Harwood, Kathleen T Call
PURPOSE: Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29304742/key-attributes-of-patient-centered-medical-homes-associated-with-patient-activation-of-diabetes-patients
#20
Lori A Bilello, Allyson Hall, Jeffrey Harman, Christopher Scuderi, Nipa Shah, Jon C Mills, Shenae Samuels
BACKGROUND: Approximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health. However, what is not well understood is the extent to which individual components of the PCMH model, such as the quality of physician-patient interactions and organizational features of care, contribute to patient activation...
January 5, 2018: BMC Family Practice
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