Blog Post

Will Patience Pay Off? A Time Frame for ROI in PCMHs

Ecg Blog Will Patience Pay Off Full Size

Real estate is traditionally considered a wise investment. But most people don’t buy a home and expect to profit by selling it just a few months later. Likewise, few new businesses yield financial windfalls overnight. Successful ventures require planning, capital, and the ability to overcome setbacks in order to evolve and ultimately flourish.

But what nearly all investments need is time. Time to grow, time to accrue value. Time to become everything their owners envision.

The same principles hold true for healthcare organizations implementing new care models, such as the patient-centered medical home (PCMH). The PCMH model emphasizes comprehensive, coordinated care with the aim of improving health outcomes and lowering costs. But similar to a new home or fledgling business, a PCMH won’t result in an immediate return on investment (ROI). In fact, organizations should not expect to see tangible ROI for at least 3 years from the initial investment.

Of course, many providers are impatient for results, especially given the pace of change in the healthcare industry. In a climate of uncertainty, providers are understandably wary of investing time and effort in a new, relatively complex care model that’s unlikely to produce many quick financial wins. But care model transformation should be an incremental process, and what an organization sacrifices in speed it can make up for in stability.

Healthcare organizations that are implementing a PCMH need to establish realistic expectations up front. By ensuring that the following steps are part of the PCMH process, organizations can enhance the value of a transformation and possibly even reduce the time needed to realize ROI:

  • Adopt a phased approach. Phasing the transition to a PCMH model can help organizations make critical adjustments without repeating costly work.
  • Revisit priorities. A calculated approach also allows for flexibility, and as the delivery model and/or patient population evolves, organizations should be prepared to redeploy assets to meet new priorities.
  • Define and implement metrics for success. Organizations must establish metrics so that they can make improvements and realize efficiencies. Some common metrics include access to care, patient satisfaction, and reduced ED utilization.

Implementing a PCMH may offer opportunities for clinical and financial improvements in the short term, but providers expecting substantial ROI need to be patient. Care model transformation is a continuous journey, just like the healthcare industry’s transition to value-based care. The financial rewards may not be immediate, but organizations that take a long-term approach will be poised to justify their risk.

For deeper insight on this topic, including PCMH investment requirements and new revenue streams, check out Producing an ROI with a Patient-Centered Medical Home, an article by Emma Mandell Gray, Senior Manager with ECG, and Rachel Aronovich, Project Manager with Northwest Hospital & Medical Center, that appears in this month’s hfm Magazine.