Medical neighborhood project aims to connect primary care practices, community providers

July 17, 2013

The Patient-Centered Medical Neighborhood (PCMN) builds on the Patient-Centered Medical Home (PCMH) concept that’s designed to improve care coordination between primary care practices and specialists.

A nationwide “medical neighborhood” pilot project aims to connect primary care practices with community-based health providers to improve care and lower costs.

The Patient-Centered Medical Neighborhood (PCMN) builds on the Patient-Centered Medical Home (PCMH) concept that’s designed to improve care coordination between primary care practices and specialists.

A total of 90 primary care practices will participate in the project, according to TransforMED, a subsidiary of the American Academy of Family Physicians (AAFP).  

“Implementing the PCMH model is critically important,” said Bruce Bagley, MD, FAAFP, interim president and CEO of TransforMED. “The context of a well-coordinated and connected medical neighborhood will not only give patients the safe, reliable and efficient care they desire, but also will increasingly empower them to manage their health in a proactive way.”

TransforMED, whose purpose is to give consultation and support to physicians transforming their practices to PCMHs, believes the project could lead to a more efficient, coordinated healthcare delivery network that improves care at a lower cost.

In attempts to understand current process and identify areas of improvement, TransforMED will meet with practice leaders to assess four areas: costs, health, patient experience, and scalability.

This three-year project, funded by a $20.75 million award by the CMS Center for Medicare and Medicaid Innovation, will involve 15 health systems in 65 cities across the country.

TransforMED plans to attain the following goals by 2015:

  • Reduce overall costs for Medicare and Medicaid beneficiaries by 4% ($49.5 million).

  • Improve the health of the eligible population by an average of 15% - and at least 3% improvement – in each selected quality measure.

  • A 25% improvement in patient experience measures that reflect patient engagement, access, and quality.

  • Demonstrate the ability to scale to additional practices within each community.