Physician Practices and Readiness for Medical Home Reforms

Policy, Pitfalls, and Possibilities

Health system reforms call for medical practices to adopt a patient-centered medical home model of care in order take advantage of health information technology and promote quality improvement. But most Americans receive health care from solo/partnership practices that do not unite primary care and specialty physicians in the same practices and do not have the structural resources for the medical home model.

These researchers sought to determine the proportion of physician practices that qualified for National Committee on Quality Assurance (NCQA) medical home standards according to practice size, organizational structure and clinical specialty.

They determined that 46 percent of all practices lack sufficient medical home infrastructure. While 72 percent of multi-specialty groups met NCQA standards, only 50 percent of solo/partnerships did. Among primary care practices, 40 percent lack the organizational resources and systems to meet minimal NCQA medical home standards.

To qualify for medical home rating—and more lucrative reimbursement levels—physicians in solo/partnership practices may be compelled to aggregate into larger groups. However, those working in rural areas may be unable to affiliate and may close their practices, impairing patient access.

The authors of this study offer one possible solution: Expand existing programs that provide technical support for clinicians adapting health information technology to also include medical home reforms for solo/partnership practices.

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