Review Article: Patient Centered Specialty Practice: A Value Based Care Solution for Urology Groups

Introduction: Patient centered medical homes have been traditionally viewed as the most logical model for the treatment and coordination of care for individuals with various conditions, although there are certain diseases for which urology groups in the form of patient centered specialty practices are better suited. We assessed the current state of urology involvement in the patient centered medical home to suggest implementation strategies for which urology based, patient centered specialty practices should be the primary contact for advanced disease states.

Methods: We conducted a review of published studies using PubMed®/MEDLINE® from database inception to 2017. Studies that contained data on urology involvement in patient centered medical homes were included, as well as governmental and agency produced reports.

Results: There is a consensus in the literature regarding an escalation of cancer care costs that are not linked to improved patient satisfaction or outcomes. Emphasis is now being placed on innovative treatment models in oncology that are based on the patient centered model and alternative, value based payments as opposed to the traditional fee-for-service approach. The oncology medical home, in the form of a patient centered specialty practice, may mitigate some of the financial burden while providing a higher quality of care and improved patient satisfaction.

Conclusions: By incorporating high quality cancer care standards such as those established by the Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine, and the Centers for Medicare and Medicaid Services urology practices can position themselves as patient centered specialty practice facilities recognized by the National Committee for Quality Assurance, which are capable of becoming the primary medical homes for patients with chronic urological conditions.