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I'm Not a Doctor

A second opinion on the challenges and opportunities facing today's physicians.
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By Andis Robeznieks

Blog: TransforMED pioneered medical home consulting

10:30 am, Feb. 26

Everyone, it seems, wants in on the medical home business, but the medical home practice implementation consulting service TransforMED got in on the ground floor.

A subsidiary of the American Academy of Family of Physicians, TransforMED was launched in June 2006 as part of the AAFP’s two-year, 36-practice national demonstration project. Eighteen of the demonstration practices were on their own, and 18 received help from TransforMED—which has since gone on to help guide almost 700 practices in adopting the medical home model. The model calls for coordinated care, a “whole-person orientation,” and increased patient access, which includes providing secure electronic doctor-patient messaging and offering same-day scheduling options.

Business is good—despite the recent and abrupt departure of Dr. Terry McGeeney, TransforMED’s founding president and CEO.

McGeeney was replaced by a familiar face, Dr. Bruce Bagley, the AAFP and TransforMED medical director for quality improvement, who is now interim president and CEO—with no plans to leave.

Bagley said he told the staff, “I’ll work every day to get the word ‘interim’ removed from my title.”

But he acknowledged that the decision to do so will be up to the TransforMED board.

Before McGeeney left, he wrote a final column for the TransforMED website. He declared that the healthcare industry is no longer changing—it has changed, and this change will result in winners and losers.

Apparently, he doesn’t believe TransforMED will be on the losing side, as—in a Dec. 5 interview on the AAFP website—he predicted 300% growth in TransforMED’s revenue in the current fiscal year.

Though Bagely did not comment on McGeeney’s prediction of TransforMED tripling its revenue this year, he did say it has recently doubled its budget and staff. He said there are now 59 TransforMED employees at its offices in Leawood, Kan., a suburb of Kansas City, Mo. (He declined to offer a similar specific number on its budget.)

“We really are a dynamic and growing organization,” Bagley said, adding that, for each job opening, TransforMED will get more than 100 applicants of which they usually interview about five. “They’re coming to the table with great skills and experience.”

Fueled by the promise of a more personally rewarding practice and new third-party payments for care-coordination services (usually in the form of a per-member, per-month fee), primary-care practices are taking a long look at adopting the medical home model. Apparently, there are so many consultants offering their medical home advice, it led the National Committee for Quality Assurance to offer consultants the opportunity to become certified as medical home content experts. Since starting its program in 2008, the NCQA has also recognized some 5,200 practices as medical homes.

And now the Joint Commission is offering medical home certification to hospital outpatient departments where primary-care services are provided.

“This is a major direction of the healthcare system,” said Lon Berkeley, co-project leader for the Joint Commission’s Primary Care Medical Home Initiative, adding that there are more than 100 medical home demonstration projects with third-party payers in progress.

Bagley said TransforMED and the NCQA's medical home recognition program “have grown up together,” but the AAFP and TransforMED do not favor any one medical home recognition or certification program over another.

Of the new Joint Commission program, he said “any program that helps address the proper implementation of the patient-centered medical home is a good thing.”

It’s good to know a good thing when you see it, and the AAFP saw the opportunity in medical home consulting first.

Follow Andis Robeznieks on Twitter: @MHARobeznieks.

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