A revolution in health care takes hold in Rhode Island

Imagine a state where all Rhode Islanders – from Woonsocket to Narragansett – enjoyed excellent health and quality of life. Instead of waiting to get sick, Rhode Islanders would be active participants in an affordable, integrated health care system that promotes wellness and delivers high quality, comprehensive primary care.
Through collaboration between our state’s business and health care sectors, small and large employers, state leaders and health care providers came to the table last month at the Rhode Island Business Group on Health’s annual Health Care Summit to discuss this shared vision and, more importantly, how it can be achieved.
The patient-centered medical home, a strategy and vehicle for realizing this shared vision, was the focus of discussion at the annual summit. By its very name, the patient-centered medical home identifies the most important piece of the health care delivery system: the patient.
The PCMH is not a place – it is a model of primary care, in which a team of doctors, nurses and other health professionals works with each patient to focus on the overall health of the person, rather than their specific condition or the cost of their care.
The patient-centered medical home is personal care in a high-tech world. The team knows the patient and his or her family and works with the patient to make treatment decisions, including best options based on the patient’s needs and preferences.
Patients and their providers are encouraged to talk in person and electronically, to ensure that patients fully understand their conditions and how to properly care for them. This model aims for a strong, long-term patient-provider relationship, with the physician taking responsibility to meet all of the patient’s health care needs and arranging care with other qualified professionals, including specialists, hospitals, home-care agencies and others, when necessary.
Physician practices that transform themselves into patient-centered medical homes offer patients enhanced access to care by more open scheduling, expanded office hours and better communication with their personal physician and care team. They focus on prevention, overall wellness and appropriate treatment, which will lead to improved care, lower costs and better health for Rhode Islanders. These are goals that all of us, including patients, employers and employees, health care providers and health care payers, can share in. These are all goals that aim to maintain high-value and high-quality care, to keep employees safe, healthy and on the job, and to improve businesses’ bottom lines.
The patient-centered medical home model of care is one that works to improve patients’ overall experience of care and better their health and wellness, all while reducing costs to families and employers. Data-driven evidence, both local and national, supports these claims.
Here in Rhode Island, the Chronic Care Sustainability Initiative is working with health care stakeholders to promote and implement the patient-centered medical-home model. Currently, 16 provider practices across the state participate in the initiative, serving more than 80,000 patients.
Initiative pilot sites are showing positive preliminary results, including increases in patient self-support management, enhanced access and communication and better care management.
We must work to ensure that all Rhode Islanders have access to a patient-centered medical home, an important strategy in long-term efforts to reform the way that health care is delivered and paid for. We encourage employers and employees to choose a physician who practices in a patient-centered medical home and to inquire with their health carrier or broker to learn more information about plan options that include patient-centered medical homes.
By empowering patients to work with their health care providers and encouraging models that focus on prevention, overall wellness and appropriate treatment, we will see improved care, lower costs and better health outcomes for Rhode Islanders, to the benefit of patients, employers and employees, insurers and providers. •


Dr. David Keller is the co-director of the Chronic Care Sustainability Initiative of Rhode Island, a clinical professor of pediatrics and a senior analyst of the Center for Health Policy and Research at the UMass Medical School. Donald Nokes is board president of the Rhode Island Business Group on Health and president of NetCenergy.

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