Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes – Commonwealth Fund – 27 February 2012

Posted on February 29, 2012. Filed under: Primary Hlth Care | Tags: , |

Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes – Commonwealth Fund – 27 February 2012

“Executive Summary

A robust primary care sector is the foundation of a more effective and efficient health care system. However, achieving a robust primary care sector will require widespread practice transformation. A growing consensus supports the patient-centered medical home (PCMH) model, proposed as joint principles by the major primary care professional associations, as the blueprint for practice transformation. Under these principles, a PCMH would provide each person with a personal physician who leads a team that takes responsibility for ongoing care for all health issues and coordinates care with other service providers. Medical homes would also ensure the quality and safety of their care through performance measurement and continuous quality improvement and provide their patients with enhanced access. Finally, payment systems would reward the added value provided by medical homes. While these joint principles describe the general expectations of a PCMH, they do not make concrete suggestions for how primary care organizations can change their practices to become one.

As part of The Commonwealth Fund’s Safety Net Medical Home Initiative (SNMHI), this report sought to develop a more detailed and concrete definition that describes the changes that most practices would need to make to become PCMHs. After reviewing the literature, the study team proposed eight characteristics of medical homes—called change concepts—which provide general directions for transforming a practice. We further identified more specific practice modifications called key changes for each change concept. A technical expert panel assembled for the SNMHI reviewed the change concepts and key changes and suggested alterations. A second panel, convened for another PCMH transformation project, also provided feedback.

Many, but not all, of the change concepts and key changes are supported by evidence of positive effects on important outcomes. Therefore, the following eight change concepts should be viewed as general guidance for transforming the practice as well as opportunities for innovation and adaptation.”


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