Feb 24

Patient-Centered Medical Home

Patient-centered medical home: Giving our practice the proper designation

An article recently published on American College of Physicians highlights the struggles that primary care physicians face these days with “rising costs, stagnant reimbursements, and a payment system that rewards quantity over quality,” and whether gaining status as a patient-centered medical home (PCMH) is the solution to these problems.1

The concept of PCMH is based on practices that seek to improve the quality, effectiveness and efficiency of care delivered. In general, PCMH describes practices that: “treat patients holistically, provides patients with extended access to providers, provides team-based care, effectively coordinates care with other providers, focuses on quality and safety, and engages patients in their own care.”1

The reason that being a recognized PCMH practice is considered a solution is due to the various benefits and rewards. One of these benefits is an increase in reimbursement for primary care services. According to Medical Economics, “in some cases, physicians have seen a 50% increase.” Reduction of costs is another benefit from applying this model.2

Why is it then that this practice has not been designated as a PCMH practice? By taking a look at the basic principles applied by PCMH, this office has been practicing accordingly as discussed in our Best Model of Care article. The practice works together as a team focusing on prevention and seeking to engage our patients in their own care, achieved by patient education and biofeedback methods like the Vascular Study. The practice also refers our patients to various specialties and coordinates with them to have proper continuity of care.

The Medical Economics article lists the biggest hurdles in achieving PCMH status, and it seems therein lies the dilemma facing this practice. One of the hurdles is “adopting electronic health records (EHRs) and using them to exchange information and analyze date.”1 As described in our previous article, More patients appreciate services provided in practice, Dr. Castellanos resists the efforts of the government to push towards the use of EHRs in order to protect our patients’ records and identities. Not only does this move subject the practice to penalties, but it seems it also prevents us from achieving a status that provides substantial rewards. Yet, his resistance to comply saves the practice and our patients the embarrassment that Anthem suffered with their recent breach.

All in all, despite not being able to achieve recognition as an official PCMH practice and receiving the benefits from it, Alexander Castellanos, M.D., Inc. is rewarded by the excellent health status of its patients, and the support, trust, and appreciation that they all have for Dr. Castellanos efforts.



1. American College of Physicians (2015). ACO or PCMH: Making a crucial decision for your practice. Retrieved from http://medicaleconomics.modernmedicine.com/medical-economics/news/aco-or-pcmh-making-crucial-decision-your-practice?page=full

2. Medical Economics (2015). Patient-centered medical home: Making care coordination work for your practice. Retrieved from http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/coordinated-care/patient-centered-medical-home-making-care-coordinati?page=full

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