Legislation would allow testing of medical home model in Dayton area

PCMHs emphasize preventive health care and are popular with doctors, nurses, employers, insurance companies and other health-care stakeholders.

But the potential inclusion of APNs in the pilot project until recently split the bill’s co-sponsors: state Rep. Peggy Lehner (R-Kettering), who sided with doctors, and state Rep. Peter Ujvagi (D-Toledo), who had backed APNs.

The latest version of the bill, to be released this week, would let four APN primary care practices be part of the pilot, in addition to 40 physician practices, 10 of which would be affiliated with Wright State University’s medical school. Funding would be sought to cut the cost of converting those practices into PCMH models.

In a nod to doctors’ concerns, the latest draft drops language specifying who may head up eligible PCMHs.

Lehner and Ujvagi, who is leaving the legislature to become Lucas County’s administrator, said Thursday they both support the latest version and plan to push forward. Lehner hopes the bill gets a vote by early March.

Lori Herf, lobbyist for the Ohio Association of Advanced Practice Nurses, said she’s glad APNs would be part of the pilot project. But she’s concerned the bill’s proposed advisory committee — on which APNs would have only 3 of 12 voting members — could define an APN primary care practice as a portion of a physician practice whose patients are seen exclusively by an APN, not as an APN-led practice.

“I want to make sure it’s clear that it’s supposed to be an APN-led practice,” Herf said.

Deleting language specifying who can lead a PCMH is a step in the right direction, said Ann Spicer of the Ohio Academy of Family Physicians, but added that her organization is not yet backing the bill.

Spicer said the bill has no dedicated funding, so any external money secured for the pilot project may specify who can and cannot lead PCMHs.

“At some point, we’re probably going to have to have the discussion” about who can lead PCMHs, Spicer said. “If we put it off now, it will come up again.”

Contact this reporter at (937) 225-7457 or bsutherly@DaytonDailyNews.com.