PCMH, ACO, Meaningful Use and Circle Jerks


A report in Health IT Analytics , as highlighted in an AAFP brief, says that the “PCMH (patient-centered medical home) model can help practices with health care reforms such as meaningful use reporting and accountable care. PCMHs stress coordinating care and maintaining patient contact, and have work flow systems and strategies to manage patient population groups, which are important to meaningful use and ACO development, the report says.”

If the above sounds like gobbledygook to you then you are not alone. The reason is that PCMH, Meaningful Use, ACOs and such are all fabricated entities meant to make the people who created them feel good about themselves.  I just found it interesting and funny how all three could be mentioned so much in the same report.  It is like some kind of administrative mega circle jerk where nothing gets done but everyone pats each other on the back.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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9 Responses

  1. Bo says:

    Umm, in terms of your back-patting conclusion, I do believe that you missed a good opportunity to capitalize on the ending in your title — i.e. the people who put all this crap together really enjoy getting each other off on it.

  2. Pat says:

    Before acceptance into med school, applicants should have to explain the above entry. If they can explain it, and still want to be physicians, then they are &$#% stupid.

  3. R Watkins says:

    And there was this gem about the supposed relationship between smoking cessation and PCMH:

    “The PCMH is allied in many circumstances with meaningful use criteria for Medicaid and Medicare,” said Goldstein, referring to the programs’ electronic health record-based incentive initiatives. “Recording smoking status and counseling on cessation can improve quality, safety, efficiency and reduce health disparities.”

    PCMH-supported quality improvements in tobacco control and prevention measures can involve creating patient advisory arrangements for tobacco users and efforts focused on increased counseling or use of pharmacotherapy for eligible individuals. Setting up a tobacco registry or giving feedback to clinicians to improve counseling rates also could help improve cessation rates, Goldstein said.”


  4. Bill Ameen, MD says:

    Dr. Doug,
    Agree as always….That PCMH is such bullshit. For over 25 years that’s exactly what I did in my walk-in urgent care, long-term continuous care, followup from hospitalizations, nursing home management, workers’ comp injuries, infants over 6 months of age, night call, weekends…and the family practice a few miles away, part of our same hospital-owned group, was deemed a PCMH and yet they referred patients to be seen by us if they were “overbooked” (I think 12-15 a day was a “full panel”), plus they were closed (and still are) all weekend. So much for a real PCMH. I thought “being there” for your patients was part of the deal.

  5. Perry says:

    Funny you should mention this, it just came up in AAFP News:

    Note the quote:
    “It also reminds us of the importance of policymaker focus on these small businesses if we are to transform the primary care delivery platform universally,” he added.

    EVERY practice should be PCMH ACO MU, etc, etc. RIP Marcus Welby.

    • Randy says:

      I don’t know if it was the intent of the ACA to put an end to solo or small group traditional practices but it does seem to be an expressed intent of the AAFP.

      I’m not surprised PCMHs do well meeting MU goals since you have employees whose job is to make sure all the little boxes get checked. Of course there’s no evidence that actually helps anything but it will make the practice look better on paper.

  6. Sir-Lance-a-Lot says:

    “…everyone pats each other on the back”

    Doug, I think the place they’re all patting each other is on the prostate.

    That would explain a lot, actually…

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