Original Article

Journal of General Internal Medicine

, Volume 25, Issue 6, pp 593-600

Open Access This content is freely available online to anyone, anywhere at any time.

Developing a Policy-Relevant Research Agenda for the Patient-Centered Medical Home: A Focus on Outcomes

  • Diane R. RittenhouseAffiliated withDepartment of Family and Community Medicine, University of CaliforniaPhilip R. Lee Institute for Health Policy Studies, University of CaliforniaCenter for Excellence in Primary Care, University of California Email author 
  • , David H. ThomAffiliated withDepartment of Family and Community Medicine, University of CaliforniaCenter for Excellence in Primary Care, University of California
  • , Julie A. SchmittdielAffiliated withKaiser Permanente Northern California, Division of ResearchCenter for Excellence in Primary Care, University of California

Abstract

Background

The Patient-Centered Medical Home (PCMH) is a widely endorsed model of delivery system reform that emphasizes primary care. Pilot demonstration projects are underway in many states, sponsored by Medicare, Medicaid, major health plans and multi-payer coalitions.

Methods

In this paper we consider the development of a long-term policy-relevant research agenda on outcomes of the PCMH. We provide an overview of potential measures of PCMH impact, identify measurement challenges and recommend areas for further study. Although the PCMH should not be expected to solve every problem in the health care system, developing a research agenda for measuring outcomes of delivery system innovations such as the PCMH should be considered in the context of the larger effort to improve the US health care system, with the ultimate goal to improve population health.

Results

As a framework for our discussion, we have chosen the Institute of Medicine’s six specific aims for 21st century health care: (1) safe, (2) effective, (3) patient-centered, (4) timely, (5) efficient and (6) equitable. In addition, we include potential areas of PCMH outcomes that do not easily fall under this framework and consider unintended consequences.

Conclusion

Multi-stakeholder involvement will be essential in developing a long-term policy-relevant research agenda for outcomes of the PCMH.

KEY WORDS

patient-centered medical home outcomes primary care physician practice health reform (or payment reform)