The Patient-Centered Medical Home (PCMH) is a care delivery model whereby patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand.

NCQA’s Patient-Centered Medical Home (PCMH) Recognition program is the most widely adopted PCMH evaluation program in the country. Approximately 13,000 practices (with 67,000 clinicians) are recognized by NCQA. More than 100 payers support NCQA Recognition through financial incentives or coaching.

The patient-centered medical home is a model of care that puts patients at the forefront of care. PCMHs build better relationships between patients and their clinical care teams. Research shows that PCMHs improve quality and the patient experience, and increase staff satisfaction—while reducing health care costs. Practices that earn recognition have made a commitment to continuous quality improvement and a patient-centered approach to care.

The concept of the “medical home” has evolved since the first introduction of the term by the American Academy of Pediatrics in 1967. At the time, it was envisioned as a central source for all the medical information about a child, especially those with special needs.Efforts by Calvin C.J. Sia, MD, a Honolulu-based pediatrician, in pursuit of new approaches to improve early childhood development in Hawaii in the 1980s laid the groundwork for an Academy policy statement in 1992 that defined a medical home largely the way Sia conceived it: a strategy for delivering the family-centered, comprehensive, continuous, and coordinated care that all infants and children deserve. In 2002, the organization expanded and operationalized the definition.

By 2005, the American College of Physicians had developed an “advanced medical home” model.This model involved the use of evidence-based medicine, clinical decision support tools, the Chronic Care Model, medical care plans, “enhanced and convenient” access to care, quantitative indicators of quality, health information technology, and feedback on performance. Payment reform was also recognized as important to the implementation of the model

Defining principles included:

  • Personal physician
  • Physician directed medical practice
  • Whole person orientation
  • Care is coordinated and/or integrated
  • Quality and safety

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