Washington Patient-Centered Medical Home Project

Submission Date: December 2013

State/Territory Submitted on the Behalf of: Washington

States/Territories Involved: Washington

Domain Addressed:

Health Systems Strategies

Public Health Issue:

Delivering high-quality care for diabetes can improve health outcomes and potentially lower health care costs and reduce disparities.

Health system interventions such as application of the evidence-based Patient-Centered Medical Home model improve the quality of care by increasing the use of and improving the effective delivery of preventive services and clinical care, helping to prevent disease, reduce risk factors, and control disease complications.

Program Action:

The Washington Patient-Centered Medical Home (PCMH) Collaborative was the most recent in a series of quality improvement collaboratives led by the Washington State Department of Health. The Washington Academy of Family Physicians collaborated with the Washington State Department of Health to enable  practice teams from 33 clinics to work together to improve primary care through adoption of the medical home model. Multiple Department of Health chronic disease programs invested in the collaborative which targeted family and internal medicine clinics selected through a competitive application process.

Participating practices served over 738,111 patients; 770 providers and ancillary clinical professionals worked at participating clinics.

Practice teams participated in learning sessions and monthly webinars led by expert faculty and received on-site quality improvement coaching and a modest stipend to compensate for time out of office to attend learning sessions (stipends were supported by partnering health plan contributions).

Impact/Accomplishments:

On average, practices’ overall score on the Medical Home Index improved over the 2-year collaborative. The Medical Home Index helps teams evaluate their integration of Medical Home into their clinical practice.

Improvements in patient health outcomes documented over 18 months included:

• Reduction from 27% to 19%in percentage of patients in poor control indicated by latest A1C > 9%
• Improvement from 40% to 50%in percentage of patients whose latest blood pressure was < 130/80 mmHg (goal level for most people with diabetes)
• Improvement from 42% to 51% in percentage of patients whose latest LDL was < 100 mg/dL (recommended goal for people with diabetes)

Improvement in patient’s diabetes care measures documented over 18 months included the following:

• Patients receiving a recommended foot exam improved from 49% to 71%
• Patients receiving medical attention for nephropathy improved from 68% to 76%
• Patients receiving a smoking query at last visit improved from 64% to 78%
• Patients receiving cessation counseling at last visit, among smokers, improved from 53% to 82%

Program Areas:

Diabetes, Heart Disease and Stroke, Public Health Practice

State Contact Information:

WA
Pat Justis, MA
Washington State Department of Health
360-236-3793
patricia.justis@doh.wa.gov

<< Back to All Success Stories