First Impression Notes From the March 30 Patient Centered Primary Care Collaborative's Stakeholder's Meeting

It's been a long but rewarding day. The Disease Management Care Blog attended the Patient Centered Primary Care Collaborative's Stakeholders' Working Group meeting at Washington D.C.'s Ronald Reagan Building. You can download most of the presentations here. While the DMCB will be reflecting on some of the Conference's more interesting speakers' over the next few days, here are some immediate insights:

The PCPCC has come a long way with an energetic and impressive leadership that has ably harnessed the talents of a cast of thousands. There was a sense of real momentum in the room.

The "Patient Centered Medical Home" clearly continues to be hot, not only because of its inclusion in health reform, but because conferences on the topic can now attract U.S. Surgeon Generals and National Coordinators for Health Information Technology. Surgeon General Benjamin extolled her many past ties to organized medicine and demonstrated her understanding of clinical practice in small town poverty, making the DMCB wonder why she wasn't more visible during the Administration's recent legislative travails. As for Dr. Blumenthal, the irony of his "I'm from the government and I'm here to help" doctors adopt meaningfully useful electronic records speech at the Reagan Center was almost too much for the DMCB to bear. Lots of coffee helped maintain focus.

There is a telling absence of breaking news about cost savings, a.k.a. claims expense reductions, a.k.a., bending the curve, a.k.a, return on investment from the medical home pilots. The focus on payment reform, blended capitation/fee-for-service/P4P/shared savings models and an interesting discussion on an alternative approach to reimbursement for measurable outcomes that are 'delegated' to medical homes made the DMCB suspect that the pilots have begun to run into the same issues that plagued early versions of the disease management industry. Hang in there says the DMCB. Not only is the science of cost analytics evolving, so is the patient centered medical home itself, including combined approaches that leverage the best of health information technology, value based insurance and modern versions of disease management. More on that in a later post.

The not-for-profit community health plans, represented by ACHP, also have yet to demonstrate hard savings from their PCMH initiatives, but there are some promising "early indicators." The DMCB also does not blame ACHP or its members for being annoyed at being swept up in the anti-insurer bombast of Ms. Sebelius.

Last but not least, the language of "Patient Centered Medical Homes" may have shifted away from jargon about 'the medical home' to rhetoric about "patient centeredness." This sometimes drifted into a parallel universe of perfectly-practiced medicine, special PCP-patient intimacy, appointments whenever wanted, limitless access to caring specialists and virtuous declines in health care costs. It also included, and the DMCB is not making this up, being a role model for "student-centered schools." The DMCB endorses the concept and votes for commuter-centered DC Metro trains, working wireless-centered wirelessness at last night's cheapo hotel and, as always, DMCB-centered spousing.

This means that in workplace meetings, conferences and career laddering sword-play with colleagues, the thousands of regular DMCB readers once again have a critical advantage. You can once again demonstrate your complete mastery of this topic by minimizing use of 'medical home' in favor of the much preferred term 'patient centeredness':

Incorrect: "This initiative is designed to promote quality and consumer value by leveraging the principles of the medical home in our network!"

Correct: "This initiative will capitalize on consumerism, leading to heightened health care value by focusing on patient centeredness in our network!"