Commonwealth Fund: Implementing Patient-Centered Medical Homes in the Veterans Administration

This Commonwealth Fund report describes how the Veterans Health Administration is implementing patient-centered medical homes.  In April 2010, the U.S. Veterans Health Administration (VA) embarked on an ambitious three-year plan to build patient-centered medical homes in more than 900 primary care clinics across the nation. Its model organizes care around an interdisciplinary team of providers who work together to increase access and clinical effectiveness by identifying and removing barriers to high-quality care. To build the teams, the VA allocated more than $227 million to hire additional clinical staff and instituted a nationwide training program that is supplemented by provider participation in regional learning collaboratives.  In one clinic, the program has shortened the waiting time for appointments from as long as 90 days to same-day access, reduced the percentage of inappropriate emergency department visits from 52 percent to 12 percent, and in just three months, reduced hemoglobin A1c scores by at least one point in 33 percent of patients with poorly controlled diabetes.

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