Nowadays, modern medicine rapidly develops the creative types of medical organizations and the tools complementing and improving them. Such models include the Patient-Centered Medical Homes (PCMHs), a renovated medical home institution, and Bundled Payment (BP) methods meant to connect individual clinical payments. Both types have additional aspects of the operation, which are linked to the terms of Accountable Care Organizations (ACOs) and Primary Care Transformation (PCT).
According to Sharma and Grumbach (2016), to achieve patient-centered care, engagement with a patient is a core strategy, and since the latter concepts are primarily meant to develop such care, it is necessary to view them in conjunction with the models. It will give the researcher a chance to uncover the bond between the concepts, as well as the main advantages and challenges standing before each organizational model.
First, one must explain the nature of PCMH before conducting the analysis. Researchers note that PCMHs are aiming to achieve three aspects, namely, to enhance quality, payment, and caring experience (Shi et al., 2016). Their main aim is focused on providing healthcare with the utmost concentration and the closest relationship to the patient himself. In turn ACO, according to Lin, Du, Gomez, and Ortiz (2017), “strives to connect physicians, hospitals, private clinics, and other health providers to improve the patient experience and patient care” (p. 188).
As for the relationship between them, the two structures appear as components of each other. In other words, ACO can and intend to unite as many PCHM as possible. The advantages for PCHM consist of the improvement in patient-centered policy via the ACOs’ help, as well as posing an example for non-PCMH institutions which can adapt their ways. However, not all clinics can timely rebuild their practice, which is why the PCMH model is not going to spread too quickly.
Technically, Primary Care Transformation can be considered one of the vital goals of PCMH. The PCT urges the clinics to modernize their primary care of the patients through individualized practice, or namely, the engagement of the patients into the healthcare decisions. Of course, PCMHs swiftly adapt to this method so they could make their activity genuinely patient-centered. However, according to Sharma and Grumbach (2016), primary care often becomes an object of criticism in case of inadequate patient engagement, so PCMH must reform its methods with caution.
Afterward, the research should explain how the two mentioned tools apply to the Bundled Payment model. According to Press, Rajkumar, and Conway (2016), the BP is “provided by clinicians, facilities, and other health care entities during an episode of care” (p. 131). Thus, patients and organizations can conduct multiple healthcare payments immediately. BP is a part of a broader alternative payments’ range, while ACOs also deploy some of the methods. Hence, the BP and ACO payments can peacefully coexist with each other and, perhaps, learn from each other as well. However, in the future, a risk of one method dominating another may appear.
Regarding the relationship between BP and PCT, the nature of it seems similar to the previous relationship with PCMH. In other words, BP and PCT can implement each other since primary patient care unavoidably faces financial questions. BP can make PCT easier and more practical since the payment issues would be resolved more quickly. Nonetheless, their indirect connection complicates the possibility of cooperation.
To sum up, it should be stated in the light of patient-centered tendencies, ACOs can widen the range of PCMH model application, though it might be harder for the minor clinics to adjust. In the case of the PCT, PCMHs strive to achieve them in the first place but must remain careful to avoid criticism for patient engagement. On the other hand, BP as an alternative payment method coexists with ACOs and simplifies the ways of operating the PCT. However, it remains a rival of ACOs’ payments and is not always directly bound with the PCT.
References
Lin, Y.-L., Du, Y., Gomez, C., & Ortiz, J. (2017). Does Patient-Centered Medical Home recognition relate to Accountable Care Organization participation? Population Health Management, 21(3), 188-195.
Press, M. J., Rajkumar, R., & Conway, P. H. (2016). Medicare’s new Bundled Payments. JAMA, 315(2), 131-132.
Sharma, A. E., & Grumbach, K. (2016). Engaging patients in primary care practice transformation: Theory, evidence and practice. Family Practice, 34(3), 262-267.
Shi, L., Lee, D.-C., Chung, M., Liang, H., Lock, D., & Sripipatana, A. (2016). Patient-Centered Medical Home recognition and clinical performance in U.S. Community Health Centers. Health Services Research, 52(3), 984-1004.