PCMH model may overlook patient experience of care in veterans

In a patient-level analysis of care at 56 sites in one region of the Veterans Health Administration, researchers reported no association between the widespread implementation of the patient-centered medical home and improvement in veterans' experience of care.

The results are published in the American Journal of Managed Care.

"Large-scale adoption of the patient-centered medical home in the Veterans Health Administration is, in part, being implemented to improve patients' experience of care," the researchers write. "But evidence is limited on the impact of medical home adoption on veterans' experience of patient care."

The researchers looked at veterans' experiences associated with Patient Aligned Care Teams, an initiative to implement the medical home model that has received more than $1 billion in VHA funding.

Although the 30,849 patient experience surveys analyzed for the study reflected a substantial increase in PACT providers, PACT quality level and the adoption of PACT structural measures, PACT had little impact on patient experience of care.

The researchers conclude that most medical home implementation efforts have focused on establishing the key structural elements of the model, but have not devoted enough emphasis to the interpersonal aspects of primary care that improve the patient experience.

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