So What Is a Patient-Centered Medical Home Anyway?

• The Patient-Centered Medical Home (PCMH) healthcare model integrates mental health providers and physicians under one system.
• This model focuses on improved patient experience, favorable mental health and physical health outcomes, and continuity of care.
• PCMH has been shown to increase recovery in patients with serious mental illness.

The mental health of many Americans is hanging in the balance. As the pandemic continues along with the economic fallout, the rates of substance abuse, anxiety, and clinical depression continue to rise. As many as one in three Americans are showing pandemic-related signs of clinical depression or anxiety. It is clear that the COVID-19 pandemic-related increase in mental health service usage has added an enormous burden to our already strained mental health infrastructure. There is an immediate and critical need for available, affordable, quality mental health services. However, issues such as lack of access, stigma, and affordability cause many Americans to go without adequate mental health treatment.

Source: Julie McMurry/Pixabay

One model that we believe may help address these issues is the patient-centered medical home (PCMH). Originally developed in 1967, the patient-centered medical home was reintroduced in the early 2000s and has been proliferating across the country since due in large part to its success in both mental health and physical health outcomes.

So what is the PCMH model all about? In summary, it is a team-based health care delivery model typically led by a primary care physician who is supported by multiple specialty providers (e.g. behavioral health, dentistry, podiatry, optometry, and nutrition). Unlike earlier patient-centered medical home models, psychiatric services are now commonly an integral component of this treatment delivery system.

The evidence shows that most mental health concerns are addressed in the primary care setting already anyway. The patient-centered medical home model embeds much-needed mental health practitioners in the medical home to serve as a resource to primary care physicians, other specialists, and patients alike.

Outcome data show that the implementation of medical homes with integrated mental health outpatient services increases mental health recovery in patients with serious mental illness, and also improves physical health outcomes, as well. Patients are also less likely to access more costly psychiatric services such as the emergency department, oftentimes precipitated by lack of access to mental health providers in the outpatient setting.

The main principles underlying the patient-centered medical home model are as follows:

1. Comprehensive and coordinated care. Treatment is provided by a multi-specialty team of providers who are integrated under one system of care. A primary health provider leads the healthcare team and delivers ongoing care to the patient. The treatment is managed across all access points including preventative, acute, or chronic.
2. Patient-centered focus. Relationship-based treatment recognizes the patient as a vital member of the treatment team. Emphasis is placed on consideration of and respecting the patients’ systems and constructs (i.e. family, cultural, sexual orientation, spiritual). Patients are encouraged to be active agents of change to improve their health outcomes.
3. Accessible services. There is an emphasis placed on increased availability of provider access with shorter wait times for available appointments. Appointments are accessible with innovative modes of communication.
4. Quality and safety. Quality and safe outcome measures are a critical component of this treatment delivery model. Evidence-based medical practices are implemented. Physicians and practitioners regularly engaged in performance measurements. Patients are encouraged to complete satisfaction surveys which are reviewed regularly.

Patient-centered medical homes are excellent systems of care to address the unmet mental health needs of a growing number of Americans. Though the practice model is different than the traditional office or clinic-based approach, the treatment outcomes are focused on similar goals—improved patient experience, favorable mental health and physical health outcomes, and continuity of care. Additionally, the patient-centered medical home delivery model is geared towards closing the gap on health disparities and decreasing healthcare costs.

We strongly believe that this model promotes the seamless integration of mental health care and physical health care which thereby promotes the whole health of the individual.