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Member Research & Reports

Member Research & Reports

George Mason: Nurse Care Coordinators are Critical to Success of Patient-Centered Medical Home Programs

Primary care providers in the CareFirst Patient Centered Medical Home (PCMH) program viewed nurse care coordinators (NCC) and individual care plans as key elements for improving primary care. The study was led by George Mason University College of Health and Human Services. Researchers held focus groups and phone interviews with doctors, clinicians, and practice managers between May 2016 and November 2017. To date, few projects have studied provider experiences with PCMH programs.

“A successful payer-based PCMH program depends on whether primary care providers believe the components are useful for improving care quality,” associate professor Dr. Gilbert Gimm explained. “Our study found that improved communication and trust between providers and payers is crucial for the success of PCMH programs.”

Primary care providers described NCCs and individual care plans as the most valuable aspects of the program. However, some reported concerns with the online data portal and a lack of trust and one-way communications with CareFirst.

In 2019, as Medicare payment changes take effect for doctors in delivery models like the PCMH, interest in successful PCMH programs by policymakers and doctors will continue to grow. The researchers suggest additional studies on the qualitative experiences of physicians in other PCMH programs are needed.

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