Article

The Patient-Centered Medical Home: Will It Stand the Test of Health Reform?

Department of Family and Community Medicine and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 30.39). 06/2009; 301(19):2038-40. DOI: 10.1001/jama.2009.691
Source: PubMed

ABSTRACT The fundamental challenge for health care reform in the United States is to expand access to all US residents, while rapidly reengineering the delivery system to provide consistently high-quality care at lower overall cost. Current reform discussions recognize that success will require a shift in emphasis from fragmentation to coordination and from highly specialized care to primary care and prevention.One prominent model of delivery system reform is the patient-centered medical home (PCMH). Crafted by the primary care professional organizations in 2007, the model has been endorsed by a broad coalition of health care stakeholders, including all of the major national health plans, most of the Fortune 500 companies, consumer organizations and labor unions, the American Medical Association, and a total of 17 specialty societies.1 Currently, 22 multistakeholder demonstration pilot projects are under way in 14 states, and the Centers for Medicare & Medicaid Services will conduct Medicare demonstration pilot projects in 400 practices in 8 regional sites in 2009.2- 3 Twenty bills promoting the PCMH concept have been introduced in 10 states.4

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    • "In addition, despite the fact that organizational solutions might vary according to the context, all of them tend to have GPs working in collaboration with other health care professionals (e.g., nurses, specialists) with the aim of organizing processes of care that are patient centered, generate a prompt and appropriate response to most common problems, avoid inappropriate and inefficient admissions to the hospital, and improve clinical outcomes (Berenson et al., 2008). The current discussions in the United States about patient-centered medical homes clearly testify to the relevance of the topic and the widespread experimentation and evaluation that is being performed with these organizational arrangements (e.g., Crabtree et al., 2011; Jaén et al. 2010; Rittenhouse & Shortell, 2009). Numerous indicators and indexes have been devised to measure the extent of implementation of the medical home model in primary care practices (Cooley, McAllister, Sherrieb, & Clark, 2003; Gilfillan et al., 2010; Jaén et al., 2010; Reid et al., 2009; Rittenhouse, Casalino, Gillies, Shortell, & Lau, 2008; Rittenhouse et al., 2011). "
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