Many Practices do not Meet National Standards for Medical Homes

Nearly half of physician practices do not meet national standards to qualify as a medical home, a new study concludes.

Nearly half (46%) of physician practices do not meet national standards to qualify as a medical home, a practice that manages ongoing care for patients and coordinates care among specialists and other health care facilities, according to a University of Michigan Health System study.

“Our study findings are particularly worrisome because the medical home model of care is seen as providing higher quality, more cost-efficient care” John Hollingsworth, MD, the lead author who conducted the study as a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan, said in a statement.

“Ideally, medical homes will help keep patients with chronic diseases from getting lost in the shuffle of our complex, fragmented health care system, yet a growing number of patients do not have access to them,” added Hollingsworth, an assistant professor of urology at the U-M Medical School. The study was published online in the journal Health Services Research.

Researchers examined data from the National Ambulatory Medical Care Survey to the National Committee on Quality Assurance’s standards for medical homes. Larger, multispecialty groups have a greater potential for meeting medical home standards, they found, but nine out of 10 Americans receive health care from physicians who practice in smaller, single-specialty groups.

Electronic health records and higher reimbursement rates for medical homes, which are supported by the Federal government, should gradually increase the number of medical homes. But Hollingsworth says that current market forces could push health care practices that do not have the infrastructure to be medical homes in the opposite direction. He adds that the push toward medical homes could inadvertently cause some practices to close and further restrict access to care, especially in rural areas.

In addition, health care disparities could be exacerbated because vulnerable populations, such as patients living below the poverty level, often see doctors in practices that do not meet standards for becoming a medical home, the research suggests.

“Patients from the poorest neighborhoods visit practices that do not meet medical home standards at higher rates than those in the more affluent neighborhoods,” Hollingsworth added. “These people are already economically disadvantaged and, on top of that, they wouldn’t have access to the potentially higher quality of care offered by this delivery system reform.”

SourceNearly Half of Physician Practices do not Meet National Standards for ‘Medical Homes’ [University of Michigan]