Patient-centered program to be tested in Dayton

A proposal would help physicians change to a patient-centered medical home model.

Dr. Ted Wymyslo, director of Family Medicine Dayton and one of the area's most passionate advocates for the idea of patient-centered medical homes, works with patient Bob Fenwick while his wife, Lois Fenwick, listens. Staff photo by Ty Greenlees

Ty Greenlees/Staff Photographer Dr. Ted Wymyslo, director of Family Medicine Dayton and one of the area's most passionate advocates for the idea of patient-centered medical homes, works with patient Bob Fenwick while his wife, Lois Fenwick, listens. Staff photo by Ty Greenlees

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By Ben Sutherly, Staff Writer 12:09 AM Saturday, May 30, 2009

A bill tapping the Dayton area and Toledo as Ohio’s testing ground for an emerging model of health care — touted as more patient-centered and less costly to employers — is to be introduced next week in the state House of Representatives.

The bill calls for spending $5.27 million, mostly federal stimulus money, through mid-2011 to help 20 physician practices in Montgomery and adjacent counties — and up to 10 more in Lucas County — make the transition to a patient-centered medical home (PCMH) model.

Most of the money would defray the cost of implementing electronic records and training staff. But $1.4 million would support the development of PCMH curricula by medical schools at Wright State University, Ohio University and the University of Toledo, and up to $300,000 would cover administrative costs.

Reps. Peggy Lehner, R-Kettering, and Peter Ujvagi, D-Toledo, are the joint sponsors of the bill submitted on Thursday, May 28, with a bipartisan coalition of 19 cosponsors.

PCMH would let family doctors get off of a “hamster wheel” of trying to see as many patients as possible to maximize revenue as their overhead costs increase and reimbursement for care stagnates.

Instead, those doctors would be paid not only a regular fee per patient visit, but also a care management fee based on education about chronic illnesses such as diabetes, as well as end-of-year performance-based payments.

Such a model hinges not only on treating illness, but on disease prevention and patients assuming an active role in their own care.

A PCMH model could reduce emergency room utilization by 20 percent and hospitalizations by 10 percent, advocates claim.

Local stakeholders, including health-insurance companies, hospital networks and other employers, and private philanthropists will need to chip in initially to save money in the long run, said Dr. Ted Wymyslo of Family Medicine Dayton, a key orchestrator in the local PCMH initiative.

The bill also would create a primary-care component of the Choose Ohio First scholarship program under which recipients would learn PCMH.

In exchange for one of at least 50 scholarships, the students would complete residency training in a family medicine, general internal medicine, or general pediatrics specialty in Ohio, and would practice family or primary-care medicine in Ohio for at least three years after residency training — a requirement meant to ease the state’s growing shortage of primary-care doctors.

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