RCHC Community Project Abstracts

A Long Road Ahead: Barriers for the transition to a patient-centered medical home model of care in the rural setting
Date of project: 2/9/2009

The “medical home” concept has emerged in recent years as a potential solution to make quality health care more affordable and accessible. It is defined as a patient-centered team effort to provide comprehensive and coordinated care over a sufficient duration of time to foster a strong level of patient-physician understanding and trust. The literature has demonstrated that this model has the ability to improve quality, reduce errors, and increase both patient and physician satisfaction. The team is a fluid network of health care professionals whose composition changes over time to meet the patient’s changing needs, with the primary care physician always operating as the team leader. The patient-centered medical home (PCMH) model also involves payment reform that compensates primary care physicians for productivity that has previously gone undercompensated, all while containing overall health costs. For small practices without pre-existing technologic or staffing infrastructure, the transition to a PCMH identity may by overwhelming or even seemingly insurmountable due to the potential for decreased productivity, financial strain, and personnel shortages. While working in the Tillamook, OR community, I investigated some of the barriers that a particular practice, Bay Ocean Medical, or others like it, might encounter should they opt to acquire that designation.

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