Assessing and Increasing Readiness for Patient-Centered Medical Home Implementation

There is widespread recognition that the current model for delivering health care in America is in need of repair. Over time, it has placed more emphasis on treating acute, episodic illness and less on proactive, preventive and consistent care over time.

One model being explored to address these concerns is the Patient-Centered Medical Home (PCMH), a delivery system method that addresses these limitations through improved care coordination across providers—often fueled by better use of health information technology—and more patient engagement. The model is being used in a variety of practice settings across the country.

This study from researchers at the University of Michigan, in collaboration with the Aligning Forces for Quality (AF4Q) evaluation team, looks at the readiness of primary care practices for implementing the PCMH model and provides guidelines for assessing and increasing its readiness. The authors conducted 66 in-person interviews at 16 primary care practices and found that motivation and capability are two critical components to implementing PCMH.

The paper's authors identified several factors that distinguished practices with high PCMH implementation scores from those with low scores, finding that practices with high scores:

  • viewed PCMH as valuable to practice and patient care
  • regarded PCMH financial incentives as offsetting costs
  • took an active role in learning about PCMH
  • embraced and promoted change related to PCMH
  • viewed resource and time barriers as challenges to overcome

AF4Q is the Robert Wood Johnson Foundation’s signature effort to improve the quality of care in the United States. This is the ninth research summary from the AF4Q evaluation team, which is studying the initiative to gain insights about community-based reform that can guide health care practice and policy.