The Qualitative and Quantitative Effects of Patient Centered Medical Home in the Veterans Health Administration

Since the 1990’s, the Veteran’s Health Administration (VHA) has implemented a system of primary care that has been considered some of the best care that can be offered (Klein, 2011). The Patient Center Medical Home (PCMH) Model, also called “Patient Aligned Care Team” (PACT) in the VHA, has been coordinating and integrating services which ensure optimal health outcomes at an acceptable value (Bidassie, Davies, Stark, & Boushon, 2014). PACT was created in 2010, building on 20 years of the VHA transforming from a loosely based system of inpatient services to a provider of outpatient primary care for veterans. From 2010 until 2011, their primary care staff levels decreased from 2.3 Full Time Equivalents (FTE) to 3.0 FTE, and in there was a reduction in face to face encounters as it was increased telephone consultations and electronic messaging (Trivedi et al., 2011). The VHA meets all five core functions under the PACT system, notably with the Peer to Peer toolkit, which permits the PCP to coordinate care with multiple specialists, and allows the exchange of electronic health records, which meets the requirements for accessible services, comprehensive care, patient centered, and coordination of care with one system (Luck, 2014). Quality metrics are hard to come by because most PCPs under the pact program see quality metrics to be a hindrance to the spirit of the PACT program, because responding to the performance metrics consume time and resources, and these quality metrics do not take into account the spirt of PCMH (Kansagara et al, 2014). The purpose of this research was to analyze the effects of PACT on the VHA to determine expenditures and the overall outcome of patient care