Establishing Federal Resources to Support Patient-Centered Medical Home Concept - 2011

Summary: The patient-centered medical home (PCMH) model is a promising strategy for transforming primary care and improving the effectiveness, efficiency, quality, and patient experience of health care. This project supported the Agency for Healthcare Research and Quality (AHRQ) and the Federal government in: 1) developing the PCMH evidence base for researchers and policymakers; and 2) establishing a conceptual framework and communications infrastructure that AHRQ can use to develop recommendations for PCMH design, implementation, and evaluation.

A medical home is not simply a place; it is a model for organizing the delivery of primary health care. AHRQ recognizes the central role of health information technology (IT) in operationalizing and implementing the key features of the medical home. Additionally, AHRQ notes that building a primary care delivery platform that the Nation can rely on for accessible, affordable high-quality health care will require significant workforce development and fundamental payment reform. Without these critical elements, primary care's potential will not be achieved.

Project Objectives:

• Conduct an environmental scan that synthesizes PCMH knowledge and issues in primary care and health policy in order to help policymakers understand emerging PCMH initiatives. (Achieved)
• Develop white papers to fill knowledge gaps on PCMH-related topics. (Achieved)
• Convene the Federal Collaborative for the Patient-Centered Medical Home to identify relevant Federal and private sector medical home initiatives and how they relate to each other. (Achieved)
• Develop a strategic plan to leverage Federal leadership and activity in developing public and private sector work on PCMHs. (Achieved)

2011 Activities: The majority of project objectives were achieved in 2010. The focus in 2011 was on developing a final report, including a description of the relevant medical home initiatives and how they relate to each other. The project was completed in March.

Impact and Findings: Over the course of the project, Dr. Peikes and her team convened the Federal Collaborative for the Patient-Centered Medical Home, consisting of 172 members representing 14 agencies and departments. The collaborative builds a common body of knowledge and fosters collaboration among the many Federal agencies that focus on primary care. Throughout this project, experts were convened to advise the project team on the conception and formulation of a series of white papers as well as a list of key foundational articles for decisionmakers.

The white papers focused on topics such as patient engagement, mental health integration, health IT, and the medical neighborhood. The papers were well received by both researchers and policymakers and helped to fill gaps in the conceptualization and understanding of key medical home concepts. In addition to the white papers, other materials were developed to fill knowledge gaps on PCMH-related topics, including:

• A briefing on care coordination in the PCMH.
• A series of decisionmaker briefs.
• A presentation at the 2011 AHRQ Annual Conference on the state of current and future research needs titled, "Patient-Centered Medical Homes: What Do We Know and How Can We Learn More".
• A scan and assessment of 99 Web sites for content related to the medical home.
• A database of citations listing the leading resources on the medical home, categorized by topic, population, bibliographical information, and keyword.
• A list of foundational articles to help decisionmakers understand the emergence of and latest thinking on the medical home.

In addition to filling knowledge gaps, the papers, briefings, and PCMH portal Web site provided key information about how the PCMH model of care can achieve the triple aims of improving the health of the population, enhancing the patient experience of care (including quality, access, and reliability), and reducing-or at least controlling-the per capita cost of care. Together with AHRQ, the project team made substantial contributions to the PCMH knowledge base, building a solid foundation for continued work in this field.

Target Population: General

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to support patient- centered care, the coordination of care across transitions in care settings, and the use of electronic exchange of health information to improve quality of care.

Business Goal: Synthesis and Dissemination