Measuring the medical home infrastructure in large medical groups

The patient-centered medical home (PCMH) is a new model of comprehensive health care delivery, coordinated across the lifespan, and payment reform that emphasizes the central role of primary care. The PCMH model includes 7 components: a personal physician, physician-directed medical practice, whole-person orientation, coordinated/integrated care, quality and safety, improved access, and payment (recognizing the added value of participating in a PCMH). Although the medical home is widely discussed by policymakers, payers, and other stakeholders, the extent to which physician practices have the infrastructure in place to function as medical homes is not known. Using data from the 2006–07 National Study of Physician Organizations, we examine the extent of adoption of medical home infrastructure components among large primary care and multispecialty medical groups and their association with medical group size and ownership. Costs of implementation, prospects for widespread adoption, and gaps between the current and potential use of PCMH are deemed essential for the success of the PCMH model.