Answer the students posts as if youre having a discussion with them. Respond by name to each student. Cite and reference if needed.

Madison wrote:
Patient-centered medical home is a model that organized and delivers primary care where the care is patient-centered, accessible, and coordinated. Quality and safety are focused on. Transforming to a patient-centered medical home model can be somewhat difficult for some facilities. It costs time, money, and several resources are needed for a smooth transition. It is important that a practice has a strong foundation when going into a transformation. Leadership should be looking at their resources and assessing their readiness to take on the challenge of a transformation. The patient-centered medical home model would require extensive training so that the staff would be able to meet the needs of their patients. For example, if there is a large elderly population, then it’s important to be prepared for that. For example, it would be beneficial to have a physician that specialized in gerontology. One benefit of a PCMH is that there would be better communication with the patients and a better understanding of the needs of patients. This would result in improved patient outcomes and satisfaction. Another benefit is that the required training would bring the staff together and create a unified team-based care. This would create efficiency throughout the practice.

Primary care is extremely important in the U.S. Primary care professionals are at the front line of healthcare. Most often, they are the ones who are seeing patient issues first, such as early signs of cancer. Through routine check-ups and follow-ups, they can catch these issues sooner rather than later and get the patient the care that they need. Adults in the U.S. who have a primary care physician have a 19% lower chance of premature death. Primary care can also save people money. Access to primary care can save people trips to the emergency room which costs tremendously more than a visit to your primary care physician. A study found that for every $1 increase in spending for primary care led to $13 in savings in overall spending.

“Lessons Learning from the Study of Primary Care Transformation”. (2013). Retrieved from https://canton.open.suny.edu/bbcswebdav/courses/202002-CAN-HSMB-410-20080/Lessons%20Learned%20from%20the%20Study%20of%20PC%20Transformation.pdf

Matuszewski, E. (2013, July 26). “Pros and Cons of the Patient-Centered Medical Home Model”. Retrieved from https://www.physicianspractice.com/blog/pros-and-cons-patient-centered-medical-home-model

“The Case for Primary Care”. (n.d.). Retrieved from https://www.primarycareprogress.org/primary-care-case/

Evelyn wrote:
As healthcare shifts their focus on preventive care, programs such as Patient-Centered Homes is an ideal way to follow patients as they progress with their care. Older patients, in particular, manage comorbidities, and it can be confusing for them to mitigate the different doctors and ancillary healthcare professionals needed for their care. According to the NCOA, 80% of older adults have at least one chronic disease, and 77% have at least 2 (NCOA, 2018).

The benefits of having a medical home are clear. The primary care provider orchestrates the care the patient needs and makes sure that the patient has access to the services required for their medical care. However, organizing the services required by some patients can become challenging. One of the biggest hurdles faced by healthcare practices is the EHR, and the fact that information technology in the healthcare industry is fragmented across medical practices. The lack of cohesion in IT makes sharing information difficult and coordinating care a challenge for healthcare providers (Nutting, 2011).

Another challenge listed by Nutting is payment reform (Nutting, 2011). How will payments be bundled? McNellis sites barriers to change and the financial costs associated with turning a practice into a Medical Home for Patients. For example, IT systems upgrades will more than likely be needed as well as extra staff. Patient care coordinators will be necessary to coordinate the various healthcare providers that may be required for a patient. Healthcare providers will also need to develop relationships with their patients so they are trusted and can receive feedback from patients McNellis, 2013).

We are in a healthcare crisis as healthcare costs continue to spiral out of control, and the government continues to cut costs to some of our critical programs such as Medicaid, leaving many individuals uninsured and unable to get treatment for chronic illnesses. The current effort to fight COVID-19 will lead to future cuts in healthcare as states, and the federal government will struggle to pay for the costs incurred from this disease. These challenges will leave fewer funds to improve infrastructure that would make medical homes a reality.

Primary care has the potential to save lives and money. Yet, the emphasis has always been on specialization, which has led to an imbalance in healthcare professionals we have today. If we had enough primary care physicians, then more preventive care could be used to treat patients instead of using acute care, as has always been the case in American medicine.

Primary physicians could catch issues early during the primary stage, instead of the secondary or tertiary stage. For example, type II diabetes is reversible if found soon enough and could save the patient from experiencing obesity, heart disease, kidney disease, and issues with eyesight. If a patient had a medical home and was monitored consistently, then health issues such as these could be avoided and save costs on healthcare.

The challenges to transforming our healthcare system seem insurmountable, especially when we cannot get policymakers to agree on what direction they are willing to take for our country. Even if the government were willing to fund efforts to transform our healthcare system, we would face other challenges such as the personnel needed to take care of patients and facilitate the change required to create medical homes for patients. There is also inequality and disparities that will not disappear until everyone has access to insurance and a primary care physician to oversee their care.

Citations

Mcnellis, R. J., Genevro, J. L., & Meyers, D. S. (2013). Lessons Learned from the Study of Primary Care Transformation. The Annals of Family Medicine, 11(Suppl_1). DOI: 10.1370/afm.1548

NCOA. (2018, June 12). Facts About Healthy Aging. Retrieved from https://www.ncoa.org/news/resources-for-reporters/get-the-facts/healthy-aging-facts/

Nutting, P. A., Crabtree, B. F., Miller, W. L., Stange, K. C., Stewart, E., & Jan, C. (2011). Transforming Physician Practices To Patient-Centered Medical Homes: Lessons From The National Demonstration Project. Health Affairs, 30(3), 439445. DOI: 10.1377/hlthaff.2010.0159

Amanda wrote:

When it comes to Patient Centered medical Homes, there are advantages and disadvantages. The U.S Department of Health and Human Services outlines advantages that include patient centered orientation, comprehensive team-based care, coordination of care, increased access to care and a focus on quality and safety (2011). One possible disadvantage is the issue that the transition to Patient Centered Home will be a lengthy progression. The article from Health Affairs outlines that this transition will require extensive collaboration and will need significant time and effort (2011). There is great importance of primary care in the United States. McNellis outlines that the primary care system is the foundation for the American healthcare system to deliver high-quality affordable care to all Americans (2013). Primary care is the first point of contact with the health care system for patients seeking treatment. Primary Care can decrease overall costs and there is continued care for patients. Patient problems can be addressed in a timely manner and overall population health can be improved. As the current primary care system is struggling there is a push to make the transition to patient-centered medical home care. There will be many challenges to transformation and transition to a PCHM. As the article Lessons Learned from the Study of Primary Care Transformation outlines, transformation will be a long and difficult journey that requires large changes to structures and systems (2013). As there is no one size fits all approach, there will be lessons learned along the way to improve the transition process. This will call for dedication and support from health care organizations.

The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care. (2011, February 1). Retrieved from https://pcmh.ahrq.gov/page/patient-centered-medical-home-strategies-put-patients-center-primary-care

Nutting, P. A., Crabtree, B. F., Miller, W. L., Stange, K. C., Stewart, E., & Jan, C. (2011). Transforming Physician Practices to Patient-Centered Medical Homes: Lessons from The National Demonstration Project. Health Affairs, 30(3), 439445. doi: 10.1377/hlthaff.2010.0159

McNellis, R. J., Ginevra, J. L., & Meyers, D. S. (2013). Lessons Learned from the Study of Primary Care Transformation. The Annals of Family Medicine, 11(Suppl_1). doi: 10.1370/afm.1548