The Patient Centered Medical Home

The Patient Centered Medical Home

History, Seven Core Features, Evidence and Transformational Change

The Patient Centered Medical Home (PCMH) is a model of care articulated by principles that embrace the aspirations of the Institute of Medicine, the design of the Future of Family Medicine new model of care and The Wagner Care Model, and the relationship desired by some of this Country’s largest employers for their employees.(12-14) It is also a political construct that takes advantage of a 40 year-old name and organizing these previous articulations into a mutually agreeable model that has now begun to capture the collective psyche of Federal and State Government, employers and health plans.(16;17) It is likely to be the best opportunity for aligning physician and patient frustration, demonstrated models for improving care, and private and public payment systems to produce the most profound transformation of the health care system in anyone’s memory.

This paper is not simply a restate- ment of the medical home, but an effort to organize some of the evidence that is foundational to the concept. It is also an effort to identify key elements of a medi- cal home for delivering a patient- centered experience. And finally, it will revisit some of the reasons for managed care’s failure lest the patient centered medical home be similarly twisted to other goals for health care.

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