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Lessons That Patient-Centered Medical Homes Can Learn From the Mistakes of HMOs

Ann M. Mirabito, PhD; and Leonard L. Berry, PhD
[+] Article, Author, and Disclosure Information

From Hankamer School of Business, Baylor University, Waco, and Mays Business School and College of Medicine Health Science Center, Texas A&M University, College Station, Texas.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictofInterestForms.do?msNum=M09-2300.

Requests for Single Reprints: Ann M. Mirabito, PhD, Hankamer School of Business, Baylor University, One Bear Place 98007, Waco, TX 76798; e-mail, Ann_Mirabito@Baylor.edu.

Current Author Addresses: Dr. Mirabito: Hankamer School of Business, Baylor University, One Bear Place 98007, Waco, TX 76798.

Dr. Berry: Mays Business School, Texas A&M University, 4112 TAMU, College Station, TX 77843.

Author Contributions: Conception and design: A.M. Mirabito, L.L. Berry.

Drafting of the article: A.M. Mirabito, L.L. Berry.

Critical revision of the article for important intellectual content: A.M. Mirabito, L.L. Berry.

Final approval of the article: A.M. Mirabito, L.L. Berry.

Administrative, technical, or logistic support: A.M. Mirabito, L.L. Berry.

Ann Intern Med. 2010;152(3):182-185. doi:10.7326/0003-4819-152-3-201002020-00011
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Patient-centered medical homes (PCMHs) have been endorsed by primary and specialty care medical associations, payers, and patient groups as an innovative structure for transforming health care delivery. The cornerstone principle of the PCMH is the primary care physician's coordination of a patient's use of health care services, including visits to specialists, to improve effectiveness and efficiency. This principle aligns with the vision behind the creation of HMOs, managed care organizations that were once embraced by physicians, patients, and policy analysts but have since lost much of their luster. Many patients and physicians rejected HMOs as too restrictive, objecting particularly to the concept of gatekeeping. This article reviews the HMO experience and identifies lessons applicable to PCMHs that build on the strengths of HMOs while avoiding their mistakes.





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