AAFP President Says Access to Care is the Most Pressing Issue in Healthcare


Patient-centered medical home is the key.

Ted Epperly, MD, says the patient-centered medical home is the key to delivering high-quality primary care to all patients

American Academy of Family Physicians President Ted Epperly, MD, recently spoke with Jackie Judd, vice president and senior advisor for communications at the Kaiser Family Foundation. They discussed current healthcare reform efforts, particularly the AAFP’s backing of the patient-centered medical home concept, which Epperly claimed “will allow all patients in America a place to be seen for preventive, acute and chronic care.”

According to Epperly, the value of the patient-centered medical home lies in the recognition that “there is both quality and lower cost if patients have a relationship with an established personal physician.” The patient-centered medical home concept of care capitalizes on the “trust and knowledge” in that relationship, said Epperly, and provides a single destination for a patient to go “with his or her physician and his or her expanded medical team” where “all of those care items can be provided in one place.” Such a care-delivery model would provide “the right place at the right time and the right type of physician, the right type of care, and in that comes healthcare quality and decreased cost,” said Epperly.

Acknowledging that family physicians, general practitioners, and other primary care physicians already do not have enough time in their busy days to spend the time with each patient the medical home model calls for, Epperly stated that the entire concept is predicated on expanding the medical team “so that we can use nurses, medical assistants, social workers, other members of the team to do much for the patient between patient education, helping them understand certain things so that the physician’s time can be leveraged for the most important items in terms of the critical thinking or the diagnosis, the management, the prescription of medications.”

Epperly emphasized an important requirement for ensuring the viability and success of the patient-centered medical home model: reimbursement reform. A transition to this method of care delivery must be accompanied by a payment mechanism (a “care management fee”) for coordinating and integrating care, what he called “non-face-to-face visit time.” He said this would “allow the patient centered medical home to provide that non-face-to-face visit time to make sure that our focus on our patients is to keep them healthy as opposed to just react to their sick care, to react to their illness.”

Paying for care delivered in a patient-centered medical home should be “a shared responsibility that can happen between insurance companies, the federal government, state Medicaid programs, health insurers, employers,” said Epperly. He and the AAFP believe that “there’s synergy in bringing this all together in one complex way that helps focus on this patient centered medical home and getting patients back to that location for the majority of their care.”

A complete transcript of the interview is available here.

A .PDF document outlining the AAFP Joint Principles of the Patient-Centered Medical Home can be accessed here.

The Patient Centered Primary Care Collaborative (PCPCC) is “a coalition of major employers, consumer groups, patient quality organizations, health plans, labor unions, hospitals, physicians and many others who have joined together to develop and advance the patient centered medical home.” Visit the PCPCC website to learn more about current efforts to promote the patient-centered medical home model.

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