Patient Centered Medical Home (PCMH)Cost of Sustaining and Transforming

以患者为中心的医疗之家 (PCMH) 维持和转型成本

• 批准号: 8628277
• 负责人: George Paul Valko
• 金额: $ 9.72万
• 依托单位: THOMAS JEFFERSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8628277
• 关键词: Patient; Centered; Medical; Home; PCMH

The patient centered medical home (PCMH) is an important model of care that is focused on improving population health through the primary care setting. While there is evidence on the activities needed to transform a practice into a PCMH, previous research into this new model of care has not focused on cost as an obstacle to transformation. In particular, cost is a barrier for smaller practices that do not have the economies of scale or capital to invest in practice transformation. However, smaller practices serve a large number of patients in the primary care setting. Thus, determining the cost of practice transformation, and allowing small practices to estimate these costs upfront, are critical steps in diffusing the PCMH model. This project has two objectives. Our first aim is to estimate the cost of transforming a small primary care practice into a patient centered medical home. Our second aim is to create a structured tool to provide practices with a way of estimating the costs of transforming themselves into a patient centered medical home. We will utilize the experiences of practices that have already made this transformation in order to achieve these two aims. The practices we analyze are all in southeastern Pennsylvania, and all had some incentives to transform into PCMH. We will supplement the experience of the study population with the experience of a large, academic practice that has transformed itself into a patient centered medical home. Our main deliverables will be a report on the costs of practice transformation and a structured tool describing the activities that practices will want to include in prospective cost analyses. Our cost report will analyze cost on financial bases currently used by practices for financial management. Our tool will take the process that we use to collect cost information, and turn it into a standardized process that other practices can use. We will combine this tool with documentation on how it can be used. The long-term goals related to our project are to transform primary care into a more patient centered activity, and to do so in a cost effective way. Our project will help us reach these goals in three ways. First, it will provide small primary care practices with a range of costs that they can use when assessing the possibility of practice transformation. Second, it will give them a tool based around specific activities that they can use to estimate these costs for their own practices. Third, it will serve as a pilot study, setting up the groundwork for a larger study of the costs of primary care transformation that would answer broader questions about cost effectiveness and the effect of to the health system. These goals are aligned with the overall goal of AHRQ, which is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. This research will support diffusion of the patient centered medical home, which is a model designed to improve health care. This research is also aligned with the Center for Primary Care with in AHRQ, as it expands the knowledge base for clinical providers and patients and to assure the translation of new knowledge and systems improvement into primary care practice.

以病人为中心的医疗之家（PCMH）是一种重要的护理模式，其重点是改善 通过初级保健环境促进人口健康。虽然有证据表明， 将实践转变为PCMH，以前对这种新的护理模式的研究并没有关注成本 是转变的障碍特别是，成本是一个障碍较小的做法，没有 规模经济或资本投资于实践转型。然而，较小的实践服务于 在初级保健环境中有大量患者。因此，确定实践转化的成本， 并允许小型实践预先估算这些成本，是推广PCMH的关键步骤 模型 该项目有两个目标。我们的第一个目标是估计改造一个小型初级保健的成本 以病人为中心的医疗之家。我们的第二个目标是创建一个结构化的工具， 实践的一种方法，估计转变为以病人为中心的医疗成本， 回家我们将利用已经实现这一转变的实践经验， 实现这两个目标。我们分析的实践都在宾夕法尼亚州东南部， 鼓励转型为PCMH。我们将补充研究人群的经验， 一个大型的，学术实践的经验，已经转变成一个以病人为中心的医疗之家本身。 我们的主要成果将是一份关于实践转变成本的报告和一个结构化工具 描述业务部门希望包括在预期成本分析中的活动。我们的成本报告 将根据财务管理实践目前使用的财务基础分析成本。我们的工具会 把我们用来收集成本信息的过程，变成一个标准化的过程， 实践可以使用。我们将联合收割机与如何使用它的文档相结合。 与我们项目相关的长期目标是将初级保健转变为更加以患者为中心的 活动，并以具有成本效益的方式进行。我们的项目将通过三种方式帮助我们实现这些目标。 首先，它将为小型初级保健实践提供一系列成本，他们可以在评估时使用 实践转化的可能性。其次，它将为他们提供一个基于特定活动的工具 他们可以用来估算他们自己的实践成本。第三，它将作为一项试点研究， 为更大规模的初级保健改革成本研究奠定基础， 更广泛的问题，成本效益和影响的卫生系统。这些目标是 符合AHRQ的总体目标，即提高质量，安全，效率， 为所有美国人提供有效的医疗保健。这项研究将支持以患者为中心的扩散 医疗之家，这是一种旨在改善医疗保健的模式。这项研究也符合 初级保健中心与AHRQ，因为它扩大了临床提供者的知识基础， 并确保将新知识和系统改进转化为初级保健 实践

项目成果

Exploring Variation in Transformation of Primary Care Practices to Patient-Centered Medical Homes: A Mixed Methods Approach.

探索初级保健实践向以患者为中心的医疗之家转变的变化：混合方法。

• DOI: 10.1089/pop.2016.0132
• 发表时间: 2017
• 期刊: Population health management
• 影响因子: 2.5
• 作者: Lieberthal,RobertD;Karagiannis,Tom;Bilheimer,Evan;Verma,Manisha;Payton,Colleen;Sarfaty,Mona;Valko,George
• 通讯作者: Valko,George

Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach.

衡量以患者为中心的医疗之家的成本：成本核算方法。

• DOI: 10.1097/jac.0000000000000196
• 发表时间: 2017
• 期刊: The Journal of ambulatory care management
• 作者: Lieberthal,RobertD;Payton,Colleen;Sarfaty,Mona;Valko,George
• 通讯作者: Valko,George