A model for patient-centered Army primary care.

This pilot evaluated a novel method of primary care delivery in a military family practice setting. A registered nurse, registered nurse case manager, and primary care provider formed the patient management team. Approximately 2,500 empanelled patients participated in a pilot program that applied a patient-centered approach to primary care. The pilot tracked outcome measures, which included (1) panel size, (2) access to care, (3) care utilization, (4) continuity of care, (5) nurse and provider productivity, (6) Healthcare Effectiveness Data and Information Set measures, and (7) satisfaction measures. When compared to the standard family practice clinic, the patients in the pilot were able to access the family practice clinic more frequently (p < 0.05), were less seen in the urgent care (p < 0.05), and had a lower no-show rate (p < 0.001) for scheduled appointments. The providers were able to see their own empanelled patients significantly more frequently (p < 0.05) and virtually all Healthcare Effectiveness Data and Information Set markers improved with colon cancer screening, low-density lipoprotein annual exams, low-density lipoprotein control, and breast cancer screening/mammogram being significantly improved over the comparison group (p < 0.05). These results suggest a change in staffing and a focus on patient-centered care can significantly improve outpatient care access and population health maintenance.