K. C. Stange, P. A. Nutting, W. L. Miller
K. C. Stange, P. A. Nutting, W. L. Miller et al., "Defining and Measuring the Patient-Centered Medical Home," Journal of General Internal Medicine, June 2010 25(6):601–12.
The patient-centered medical home (PCMH) is emerging as a critical tool in reforming U.S. health care. However, it is not widely known what a medical home is or how it can function effectively. In an article appearing in a supplement to the Journal of General Internal Medicine, researchers led by Kurt C. Stange, of Case Western Reserve University define the PCMH as team of people committed to improving the health and healing of individuals in a community. Transforming a medical practice to a PCMH requires a focus on the fundamental tenets of primary care (e.g., accessibility, comprehensiveness, coordination and integration, and relationships), new ways of organizing care (e.g., electronic visits and team-based care), developing internal capabilities (e.g., leadership and management structure), and making reimbursement changes (e.g., blended payments and care management fees). The authors also outline principles for measuring PCMHs. Among other recommendations, they suggest measuring the quality and function of relationships with patients and health care system and community partners, and using both numbers and narratives to measure aspects of the PCMH. Evaluation efforts, they warn, should recognize that a five- to 10-year time horizon is needed to see the full health and economic effects of the PCMH.
This research was supported by The Commonwealth Fund, the Agency for Healthcare Research and Quality, and the American Board of Internal Medicine Foundation.