Impact Of Patient-Centred Medical Home Transformation On Patient Experience: An Evaluative Case Study

Abstract:

Aim

The Patient-Centred Medical Home (PCMH) model is designed to address and improve several aspects of the organization and delivery of primary care, including access to services, the coordination of care across multiple providers, and the treatment of complex chronic illnesses—all while ensuring that care is patient-centred. While the implementation of this model has been growing rapidly across the United States, information about its influence on patients’ experiences of care is limited.

The CAHPS® team is conducting research to identify the specific PCMH-related activities that may affect patient experiences, the successes and challenges involved in implementing these activities as they affect patient experience, and the usefulness of data from the CAHPS Clinician & Group (CG-CAHPS) Survey in this process.

Anticipated Benefits

Comparing physician practices that have fully implemented the PCMH model with those that have not is an important step toward understanding the impact of PCMH transformation on patient experience. This approach also is important for identifying those activities that could maximize the PCMH model’s capacity to improve patient experiences.

Approach

Members of the CAHPS team partnered with AltaMed, a large Federally Qualified Health Centre in California. AltaMed’s 14 primary care clinics have been certified by the National Committee for Quality Assurance (NCQA) as Level 3 Patient-Centred Medical Homes. Using 3 years of CG-CAHPS Survey data, the team is assessing the level of performance and changes in patient experience scores within the clinics as they implement different features of PCMH (e.g., care coordinators, health educators, PCMH and Interdisciplinary team meetings, and daily huddles).

The team has also conducted 40 interviews at the 14 sites to learn how the site leaders use CG-CAHPS Survey data during PCMH transformation and how practice leaders, clinicians, and clinic staff perceive the impact of PCMH-related changes on the patient visit.

Initial Findings

CAHPS patient experience scores for clinics with PCMH features (particularly in the area of chronic care management) were higher for provider communication, follow-up on test results, and overall perceptions of the primary care provider than those of other clinics.

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