Defining and Measuring the Patient-Centered Medical Home
The patient-centered medical home (PCMH) is four things: 1) the fundamental tenets of primary care: first contact access, comprehensiveness, integration/coordination, and relationships involving sustained partnership; 2) new ways of organizing practice; 3) development of practices’ internal capabilities, and 4) related health care system and reimbursement changes. All of these are focused on improving the health of whole people, families, communities and populations, and on increasing the value of healthcare.
The value of the fundamental tenets of primary care is well established. This value includes higher health care quality, better whole-person and population health, lower cost and reduced inequalities compared to healthcare systems not based on primary care.
The needed practice organizational and health care system change aspects of the PCMH are still evolving in highly related ways. The PCMH will continue to evolve as evidence comes in from hundreds of demonstrations and experiments ongoing around the country, and as the local and larger healthcare systems change.
Measuring the PCMH involves the following:
Giving primacy to the core tenets of primary care
Assessing practice and system changes that are hypothesized to provide added value
Assessing development of practices’ core processes and adaptive reserve
Assessing integration with more functional healthcare system and community resources
Evaluating the potential for unintended negative consequences from valuing the more easily measured instrumental features of the PCMH over the fundamental relationship and whole system aspects
Recognizing that since a fundamental benefit of primary care is its adaptability to diverse people, populations and systems, functional PCMHs will look different in different settings.
- Defining and Measuring the Patient-Centered Medical Home
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of General Internal Medicine
Volume 25, Issue 6 , pp 601-612
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- primary care
- patient-centered medical home
- quality improvement
- Industry Sectors
- Author Affiliations
- 1. Family Medicine, Epidemiology & Biostatistics, Sociology and Oncology, Case Western Reserve University, 10900 Euclid Ave, LC 7136, Cleveland, OH, 44106, USA
- 2. Case Comprehensive Cancer Center, Case Western Reserve University, 10900 Euclid Ave, LC 7136, Cleveland, OH, USA
- 3. University of Colorado Health Sciences Center, Denver, CO, USA
- 4. Center for Research Strategies, Denver, CO, USA
- 5. Leonard Parker Pool Chair of Family Medicine, Allentown, PA, USA
- 6. Lehigh Valley Health Network, Penn State College of Medicine, Allentown, PA, USA
- 7. Family & Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- 8. Epidemiology & Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- 10. Program Leader in Population Sciences, Cancer Institute of New Jersey, Somerset, NJ, USA
- 9. Department of Family Medicine, Robert Wood Johnson Medical School, Somerset, NJ, USA
- 11. Department of Family Medicine, Epidemiology & Biostatistics and Oncology, Case Western Reserve University, Cleveland, OH, USA
- 12. Delaware Valley Outcomes Research, Newark, DE, USA
- 13. Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA