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Live chat on the Patient-Centered Medical Home
October 8th, 2009


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Welcome to the live web discussion on the Patient-Centered Medical Home, led by Paul Grundy M.D. and John Rogers M.D.

Please join the conversation. Simply enter your name and organization and jump into the conversation.

Leading the web conversation will be Paul Grundy M.D. and John Rogers M.D. Dr. Grundy is the Chairman of the Patient Centered Primary Care Collaborative, representing employers of 50 million people in the United States,  physician groups representing over330,000 medical doctors, leading consumer groups, along with the top seven US health-benefits companies.  Paul is also IBM’s Global Director of Healthcare Transformation.

Dr. Rogers is the interim chair and professor at the Baylor School of Medicine, Family Medicine Clinic and the recent past president of the society of Teachers of Family Medicine.

Get a head start on the conversation

To provide more context for the conversation and background on the patient-centered medical home issue, we encourage you to look through some of the following links:

Be the first to ask a question

Do you have questions you want Dr. Grundy and Dr. Rogers to address? Leave a comment below and they’ll be sure to address those questions first.

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November 2, 2009
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How should recognition criteria for well-functioning PC-MH’s evolve beyond current initial attempts at this (e.g. NCQA criteria, TransforMed’s MH-IQ, Minnesota’s Health Care Home recognition criteria), in order to better reinforce and value longitudinality/continuity of care? The “personal physician” is a foundational Joint Principle of the PC-MH for important reasons. Clinicians who know and are trusted by their patients, help to guide patients in the most accurate and cost effective, and relevant, ways. Clinics which maximize how and how often patients can see the providers that they know and trust, demonstrate superior outcomes in value. Health systems that construct cultures of consultation and communication which pointedly aim at utilizing fully what personal clinicians know about their patients, ensure best that all of the care offered and delivered to those patients is coordinated, accurate, and patient centered. What measures of this are being developed, and how can we educate and reinforce clinics and systems wishing to become recognized as high functioning PC-MH’s to focus on these themes as important goals?

Posted by: David Hutchinson, MD, past president, Minnesota Academy of Family Physicians
October 29, 2009
7:23 pm

With PCMH not fully functional yet, how should teach medical students? What methods would you suggest?

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October 29, 2009
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I am unable to join the webcast. You website instructs me to simple enter my name and organization, but there is nowhere I can find to enter this information.

Posted by: Diane Flynn, MD
October 29, 2009
6:33 pm

What are your thoughts on the design of physician compensation in the PCMH? The payors are designing some care management fee (PMPM) plus fee-for service, so we have not truly moved from value to volume in incentives. A lot of the care management fee will go to non-physician costs of staff and technology.

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October 29, 2009
6:09 pm

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October 29, 2009
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Is there audio that goes with this?

Posted by: Hali Hammer
October 29, 2009
5:58 pm

How are primary care physicians paid under a Patient Centered Medical Home approach?

Well right now it depends on where you practice in some states like Wi, PA VT and NC one gets a per member per month in Wi that is $12 or or $144 per year. In fact a range of payment methods have been proposed or are currently being tested to compensate PCPs for serving as medical homes. Most, like the CMS’s and the Colorado pilot, involve a per-patient monthly management fee (of roughly $40 or more, depending on the population served) on top of the fee-for-service payment or other reimbursement. Some methods add a performance bonus for meeting targeted quality indicators, and certain payer/insurer initiatives also incorporate a prospective payment to help practices absorb technology costs. We need to find ways to start paying PCPs a lot more. In exchange we need to hold them accountable to invest in modern care management/clinical decision support tools, 3) hold specialists accountable to collaborate with the primary care provider on their patients’ care in a PCMH.

In MI the blues pay there is a t code that is used for non physician services like care coordination, patient education, emails. What we are asking for is s

Posted by: paul Grundy
October 29, 2009
10:33 am

What have we learned so far from the P4 endeavor about incorporating PCMH principles into Family Practice resident education?

Posted by: Ted Wymyslo
October 28, 2009
6:00 pm

Will hospital based clinics vs. community based clinics be paid differently under the PCMH approach? Are there special issues for payment for FQHCs and FQHC-look-a-likes for this

Posted by: Janice L. Benson, MD
October 28, 2009
5:43 pm

How do we best introduce the PCMH concepts to medical students?

Posted by: Holly Cronau
October 28, 2009
5:02 pm

How to get buy-in from medical staff, faculty and residents to develop and implement a model of the PCMH approach? Please provide examples of overcoming resistance.

Posted by: Jose R Nino
October 27, 2009
6:08 pm

How are family physicians, pediatricians and general internists in training being educated differently to deliver care in the Patient Centered Medical Home?

Posted by: Jay Fetter
October 27, 2009
1:37 pm

How does technology fit into team-based care?

Posted by: Laurie Friedman
October 27, 2009
1:19 pm

How are primary care physicians paid under a Patient Centered Medical Home approach?

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