Ohio to invest $1 million in patient-centered care

(AP)  COLUMBUS, Ohio — Ohio plans to spend $1 million to expand an approach to primary care that encourages the family doctor to better coordinate with specialists and others to improve a patient's health, state health officials said Wednesday.

The investment will help 50 facilities transition into so-called patient-centered medical homes around Ohio. The sites also will serve as a training ground for medical and nursing students who want to learn how to deliver care in the new model.

Under the approach, primary care providers would coordinate patients' care so that there aren't duplicative tests or unnecessary hospital or emergency room visits, among other issues. Students also would be eligible for scholarships to a program that allows them to learn alongside staff at the state-selected 50 medical practices.

The $1 million will be spent to train roughly 1,000 to 1,500 doctors, nurses and others to better handle electronic medical records, create disease registries and more efficiently schedule patients so there's enough time for emergency visits or follow-up appointments. The approach also encourages primary care providers to be more proactive in reaching out to patients in new ways — whether that's through their email or cellphones.

"It really is getting us up to the 21st century in the way we practice medicine," Ted Wymyslo, the director of the state's health department, said at a news conference.

Backers of the approach say it leads to better health outcomes and reduces costs to individuals and taxpayers.

A state law signed in 2010 helped pave the way for 44 sites, but state lawmakers at the time did not provide any money to support the practices' transition to medical homes.

Wednesday's announcement fully funds training at those sites and opens up the door for six more medical homes, officials said.

Training could start at the facilities as soon as April, with students likely joining the staff to learn in the fall, Wymyslo said. The training would occur over two years.

The state will give priority for the additional six sites to practices that serve underserved or minority populations. At least 15 percent of every practice that receives training dollars must support either uninsured or Medicaid-eligible Ohioans.

The $1 million investment comes from the governor's newly created Office of Health Transformation, which had been allotted $8 million in federal bonus money through the state budget for office operations, consulting and other projects.

Greg Moody, the office's director, said the administration had not originally planned to fund the medical home initiative from this source, but it fits the office's goal of delivering more effective care.

"This is not giving them money to practice," Moody said. "This is giving them training support to be able to convert in a way that is actually sustainable."

State Sen. Peggy Lehner, who sponsored law when she was in the Ohio House, said she recognized the time, stress and money involved in changing a well-established, over-worked practice into a technology-driven, team-oriented medical home. And, she said, "it made a lot more sense to train medical students, residents and nurse practitioners in this model from the very beginning."

The head of the Ohio Commission on Minority Health praised the state's investment.

"Patient-centered medical homes have shown promise in other states in eliminating health care disparities within racial and ethnic populations," Angela Cornelius Dawson, the commission's executive director, said in a statement.

Patient-centered medical homes started in the late 1960s to help children with complex medical problems. The concept took off in primary care a few years ago, as insurers and doctors looked for alternatives to a system with soaring costs.

As of December, the state had 104 medical practices in Ohio that were recognized as medical homes by the National Committee for Quality Assurance, a nonprofit organization that monitors health care.

That's up from 10 practices a year and a half ago, Wymyslo said.

Dr. Randy Wexler, who practices at a recognized medical home in the Columbus suburb of Gahanna, said he's seen through his office how the approach is better for patients.

As an example, Wexler said his office blocks off 17 percent of their visits every day for what he calls "sick calls."

"A patient calls first thing that morning, they can be seen that day," he said. "We provide the care to them where they're comfortable, where they're used to going, and where we know their background. We think that's a good way to provide care."

[JEngdahlJ]

Medical homes face a public awareness problem. The solution? Scenarios that work. http://www.healthcaretownhall.com/?p=2880