Using CAHPS patient experience data for patient-centered medical home transformation

Patient-centered medical home (PCMH) has spurred primary care reform and improvements in patient care quality. Very little is known about the differences practices implement during PCMH transformation. We examined 105 primary care practice leader experiences during PCMH transformation, asking in semi-structured interviews about the changes they targeted. We used content analysis to classify these PCMH changes and examined how they aligned with what is measured on PCMH-recommended patient experience surveys. During PMCH transformation, practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas of PCMH transformation were measured by Clinician & Group Consumer Assessment of Healthcare Providers and Systems (CAHPS), PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more services on site (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS patient experience items; some are not. For some uncaptured areas, patients are not the best source of information. To provide practice leaders information they need for PCMH transformation, CAHPS items need to measure care management to support medical and chronic conditions, and chronic condition health education.

Download Full-text

Patient experience at the time of practice transformation into Patient-Centered Medical Homes

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v1i2.662 ◽

2013 ◽

Vol 1 (2) ◽

pp. 290 ◽

Cited By ~ 1

Author(s):

Lisa Kern ◽

Rina Dhopeshwarker ◽

Alison Edwards ◽

Rainu Kaushal

Keyword(s):

Primary Care ◽

Patient Experience ◽

Medical Home ◽

Primary Care Physicians ◽

New York State ◽

Patient Centered Medical Home ◽

Cross Sectional Survey ◽

Patient Centered ◽

Processes Of Care ◽

Patients Experience

Purpose: The Patient-Centered Medical Home (PCMH) is a model of primary care that is being promoted for its potential ability to improve patient-centeredness, improve quality and decrease costs. The effect of the PCMH on patient experience is not clear, with some reports suggesting that patient experience may worsen during transformation. We sought to measure patient experience at the time practices transform into PCMHs.Methods: We conducted a cross-sectional survey of 419 adult patients who were cared for by 85 primary care physicians across 12 practices in the Hudson Valley region of New York State. We measured patient experience, using the 35 questions in the Clinician & Group – Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) – Adult Primary Care Questionnnaire (plus 14 additional questions drawn from other survey instruments) and compared the results to national CG-CAHPS benchmarks.Results: Patients’ experience overall was fairly positive, with 79% giving their doctors a ranking of 9 or 10 on a 10-point scale, with 10 being the highest. Patients’ experience in this sample was significantly more positive than the national benchmark on each of 6 subscales (p ≤ 0.05). Patients were generally most satisfied with individual face-to-face encounters with their physicians and somewhat less satisfied with processes of care (such as receiving results from a test or receiving follow-up after discharge from the hospital).Conclusions: This study suggests that medical home transformation does not adversely impact patient experience and identifies organizational processes of care that could potentially be improved with the patient-centered medical home.

Download Full-text