The post-katrina conversion of clinics in new orleans to medical homes shows change is possible, but hard to sustain

Health Affairs

Volumn 31, Issue 8, 2012, Pages 1729-1738

  Rittenhouse, Diane R ^a   Schmidt, Laura A ^b   Wu, Kevin J ^b   Wiley, James ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; FUNDING; HEALTH CARE ACCESS; HEALTH CARE FACILITY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HUMAN; HURRICANE; OBSERVATIONAL STUDY; PRIMARY MEDICAL CARE; SAFETY; SURVIVAL; UNITED STATES;

COMMUNITY HEALTH CENTERS; CYCLONIC STORMS; DISASTERS; HEALTH FACILITY PLANNING; HEALTH SERVICES ACCESSIBILITY; NEW ORLEANS; ORGANIZATIONAL INNOVATION; PATIENT-CENTERED CARE;

EID: 84866322173     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2012.0402     Document Type: Article

References (34)

1. American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association. Joint principles of the patientcentered medical home [Internet]. Elk Grove Village (IL): American Academy of Pediatrics; 2007 Mar [cited 2012 Jul 9]. Available from: http://www.medicalhomeinfo.org/ downloads/pdfs/JointStatement.pdf
2. Patient-Centered Primary Care Collaborative. Collaborative members [Internet]. Washington (DC): The Collaborative; [cited 2012 Jul 9]. Available from: http://www.pcpcc.net/content/collaborative-members
3. Bitton A, Martin C, Landon BE. A nationwide survey of patient centered medical home demonstration projects. J Gen Intern Med. 2010; 25(6):584-92.
4. Takach M. Reinventing Medicaid: state innovations to qualify and pay for patient-centered medical homes show promising results. Health Aff (Millwood). 2011;30(7):1325-34.
5. Reid RJ, Fishman PA, Yu O, Ross TR, Tufano JT, Soman MP, et al. Patientcentered medical home demonstration: a prospective, quasiexperimental, before and after evaluation. Am J Manag Care. 2009;15(9):e71-87.
6. Reid RJ, Coleman K, Johnson EA, Fishman PA, Hsu C, Soman MP, et al. The Group Health medical home at year two: cost savings, higher patient satisfaction, and less burnout for providers. Health Aff (Millwood). 2010;29(5):835-43.
7. Paulus RA, Davis K, Steele GD. Continuous innovation in health care: implications of the Geisinger experience. Health Aff (Millwood). 2008;27(5):1235-45.
8. Solberg LI, Asche SE, Fontaine P, Flottemesch TJ, Pawlson LG, Scholle SH. Relationship of clinic medical home scores to quality and patient experience. J Ambul Care Manage. 2011;34(1):57-66.
9. Grundy P, Hagan KR, Hansen JC, Grumbach K. The multi-stakeholder movement for primary care renewal and reform. Health Aff (Millwood). 2010;29(5):791-8.
10. Rittenhouse DR, Shortell SM. The patient-centered medical home: will it stand the test of health reform? JAMA. 2009;301(19):2038-40.
11. For brevity, we use New Orleans to refer to a four-county region that includes the city of New Orleans. The four counties, or " parishes," are Jefferson, Orleans, Plaquemines, and St. Bernard.
12. Desalvo KB, Muntner P, Fox CE. Community-based health care for " the city that care forgot." J Urban Health. 2005;82(4):520-3.
13. Rudowitz R, Rowland D, Shartzer A. Health care in New Orleans before and after Hurricane Katrina. Health Aff (Millwood). 2006;25(5):w393- 406. DOI: 10.1377/hlthaff.25.w393.
14. Taylor J. The primary care safety net: strained, transitioning, critical [Internet]. Washington (DC): National Health Policy Forum, 2010 Sep 28 [cited 2012 Jul 9]. (Background Paper No. 79). Available from: http://www.nhpf.org/library/backgroundpapers/BP79_PrimaryCareSafetyNet_09-28-10.pdf
15. Louisiana Public Health Institute. Primary Care Access and Stabilization Grant (PCASG) quality improvement program [Internet]. New Orleans (LA): LPHI; 2008 Jun 23 [cited 2012 Jul 9]. Available from: http://www.lphi.org/LPHIadmin/uploads/PCASG-QI-Plan-June-23-2008-07-10-08-23170.pdf
16. Rittenhouse DR, Casalino LP, Shortell SM, McClellan SR, Gillies RR, Alexander JA, et al. Small and medium-size physician practices use few patient-centered medical home processes. Health Aff (Millwood). 2011;30(8):1757-84.
17. National Committee for Quality Assurance. Patient-centered medical home. Washington (DC): NCQA; 2011 [cited 2012 Jul 9]. Available from: http://www.ncqa.org/tabid/631/default.aspx
18. To access the Appendix, click on the Appendix link in the box to the right of the article online
19. Lousiana Public Health Institute. Primary Care Access and Stabilization Grant [Internet]. New Orleans (LA): LPHI; [cited 2012 Jul 9].; Available from: http://lphi.org/home2/section/3-146/primary-careaccess-and-stabilization-grant
20. Rittenhouse DR, Casalino LP, Gillies RR, Shortell SM, Lau B. Measuring the medical home infrastructure in large medical groups. Health Aff (Millwood). 2008;27(5):1246-58.
21. Data from an unpublished patient survey (see Note 22) at twenty-four of the fifty-one clinics included in this analysis indicate that the patient population was 58.6 percent black, 15.6 percent white, 0.9 percent Asian, 2.4 percent other, and 22.5 percent unknown. The ethnicity of 25.8 percent of the patients was unknown; 68.2 percent were non-Hispanic; and 6.0 percent were Hispanic.
22. Schmidt LA, Rittenhouse DR, Wu KJ, Wiley JA. Transforming primary care in the New Orleans safety net: the patient experience. Med Care. Forthcoming.
23. Nutting PA, Crabtree BF, Miller WL, Stange KC, Stewart E, Jaén C. Transforming physician practices to patient-centered medical homes: lessons from the national demonstration project. Health Aff (Millwood). 2011;30(3):439-45.
24. Rittenhouse DR, Shortell SM, Gillies RR, Casalino LP, Robinson JC, McCurdy RK, et al. Improving chronic illness care: findings from a national study of care management processes in large physician practices. Med Care Res Rev. 2010;67(3): 301-20.
25. Qualis Health. Patient-centered medical homes [Internet]. Seattle (WA): Qualis Health; [cited 2012 Jul 18]. Available from: http://www.qualishealth.org/healthcareprofessionals/patient-centeredmedical-homes
26. Health Resources and Services Administration. HRSA Patient-Centered Medical/Health Home Initiative [Internet]. Rockville (MD): HRSA; [cited 2012 Jul 18]. Available from: http://bphc.hrsa.gov/policiesregulations/policies/pal201101.html
27. Friedberg MW, Safran DG, Coltin K, Dresser M, Schneider EC. Paying for performance in primary care: potential impact on practices and disparities. Health Aff (Millwood). 2010;29(5):926-32.
28. Grumbach K, Mold JW. A health care cooperative extension service: transforming primary care and community health. JAMA. 2009; 301(24):2589-91.
29. Maxson E, Jain S, Kendall M, Mostashari F, Blumenthal D. The regional extension center program: helping physicians meaningfully use health information technology. Ann Intern Med. 2010;153(10):666-70.
30. Nutting PA, Crabtree BF, Stewart EE, Miller WL, Palmer RF, Stange KC, et al. Effect of facilitation on practice outcomes in the National Demonstration Project model of the patientcentered medical home. Ann Fam Med. 2010;8(Suppl 1):S33-44; S92.
31. Blumenthal D, Tavenner M. The " meaningful use" regulation for electronic health records. N Engl J Med. 2010;363(6):501-4.
32. Office of the National Coordinator for Health Information Technology. Beacon Community Program [Internet]. Washington (DC): ONC; [page last updated 2012 Jun 29; cited 2012 Jul 10]. Available from: http://healthit.hhs.gov/portal/server.pt?open=512&objID=1805&parentname=CommunityPage&parentid=2&mode=2&cached=true
33. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington (DC): National Academies Press; 2001.
34. Smedley BD, Stith AY, Nelson AR, editors. Unequal treatment: confronting racial and ethnic disparities in health care. Washington (DC): National Academies Press; 2003.