Executive Summary
Introduction
This synthesis report presents an overview of the Patient-Centered Medical Home (PCMH), including key
features, discussion of federal, state, and private sector medical home models, and considerations for
hospitals interested in developing a PCMH.
What is a Patient-Centered Medical Home?
The medical home concept, which was originally developed in the 1960s, refers to the provision of
comprehensive primary care services that facilitates communication and shared decision-making between
the patient, his/her primary care providers, other providers, and the patient‘s family. The PCMH concept
was included as a program in national health care reform legislation with components similar to joint
principles developed by the American Academy of Family Physicians (AAFP), American Academy of
Pediatrics (AAP), American College of Physicians (ACP), and the American Osteopathic Association
(AOA):
Personal physician – Each patient has an ongoing relationship with a personal physician trained to
provide first contact, continuous, and comprehensive care.
Physician directed medical practice – The personal physician leads a team of individuals at the
practice level who collectively take responsibility for the ongoing care of patients.
Whole person orientation – The personal physician is responsible for providing for all the patient‘s
health care needs or taking responsibility for appropriately arranging care with other professionals.
Care is coordinated and/or integrated across all elements of the complex health care system (e.g.,
subspecialty care, hospitals, home health agencies, nursing homes) and the patient‘s community.
Quality and safety are hallmarks of the medical home, supporting the attainment of optimal, patient-
centered outcomes.
Enhanced access to care is available through systems such as open scheduling, expanded hours,
and new options for communication between patients, their personal physician, and practice staff.
Payment appropriately recognizes the added value provided to patients who have a PCMH.
The specific role of hospitals in a PCMH
The definition and structure of most PCMH initiatives do not include a unique role for hospitals. However
hospitals can participate in the PCMH model in a supportive, complementary role to primary care
practices, in the following ways:
Convene physicians
Offer capital and IT infrastructure
Offer staff resources and other functionalities
Serve as a catalyst and offer management expertise
Serve as an administrator of bundled payment
Hospitals looking to participate in a PCMH can get started with the following recommended steps:
Assess current organizational capabilities and resources
Identify opportunities in the community for partnership
Conclusion
The PCMH model offers significant promise as a method of both improving the patient experience and
reducing cost. Hospitals face the challenge of not having a defined role in the PCMH model. Still,
researchers believe that hospitals will begin a migration to embrace the PCMH model in coming years as
a natural extension of clinical IT investments and increasing care coordination (Deloitte, 2008).
