Patient Centered Medical Homelessness


So the big news out of JAMA was this study, which concluded:

A multipayer medical home pilot, in which participating practices adopted new structural capabilities and received NCQA certification, was associated with limited improvements in quality and was not associated with reductions in utilization of hospital, emergency department, or ambulatory care services or total costs over 3 years. These findings suggest that medical home interventions may need further refinement.

Was there any reader of this blog who was surprised by this?  I have been blasting this farce for YEARS!  What was funny was this study was sent to me by a bunch of you guys, even before I saw it.  Thank you.  Your initial thoughts included:

  • So If my reading skills are good, millions of dollars were spent on this study, and hundreds of millions nationally on ‘Medical Homes’, and the only measurable improvement was more microalbumin testing?  And we’re supposed to have all our diabetics on ACE/ARB anyways so that microalbumin is a test without an intervention?  Shouldn’t we just pay FP’s more, and let them create their own ‘Medical Homes’, also known as Practices?  I know, I’m preaching to the choir.
  • I’ve never been an AMA member, but they’ve been sending me JAMA for the last decade.  Absolutely devastating.

So, now that the government and hospitals and insurers bought into this crap hook, line and sinker, what kind of further refinement do you think is going to happen?   My guess is that they will focus on the money aspect and cut out the physicians some more because, obviously, they are costing too much.   Maybe an addition of a few more administrators should help, too.

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