I read with interest a recent article in the Journal of Oncology Practice[1] about Dr. Barbara McAneny of New Mexico Cancer Center and her project to develop a patient-centered medical home (PCMH) model for cancer care. The goal of a PCMH is to improve patients’ experiences and outcomes at a lower cost than what a traditional cancer center spends per patient. The managing company Innovative Oncology Business Solutions (IOBS) has been given $19 million from the Centers for Medicare and Medicaid Services (CMS) and 3 years to create a cost-saving PCMH. IOBS plans to hire 115 new positions in order to implement their goal of saving CMS $33 million over the 3 years—and this is with only seven different oncology practices participating.

The two key expenses targeted by the group are emergency room visits and inpatient hospitalizations, with smaller savings expected from lowering drug usage, by adhering more closely to treatment guidelines, and earlier transitioning of patients to hospice care. In order to achieve these goals, IOBS has established multiple features to “ensure safe, efficient, and high-quality care.”[1] After reading these features I was amazed at how similar their ideas of a medical home are to mine. Could our humble practice be evolving toward the definition of a medical home with zilch for funding?

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