The patient centered medical home: moving from dialogue to implementation

Primary care continues to suffer a loss of interest among graduates of medical school. The patient-centered medical home (PCMH) provides a potential vehicle to redefine primary care as chronic disease increases in prevalence in the United States. The model, as developed by the American Osteopathic Association, American Academy of Family Physicians, American Academy of Pediatrics, and American College of Physicians provides a organized team focused on engaging and collaborating with patients and family using evidenced-based, goal-directed therapy. Challenges for primary care include practice expansion in terms of information technology and human resources to meet the needs of patents in terms of primary and secondary prevention as well as care coordination. Payment methods to fund these changes are being explored by several states through pilot projects. Although the PCMH has shown early evidence in its ability to improve both physicians' satisfaction with practice and patients outcomes, broad implementation will not occur without payers and employers realizing the value of the PCMH and providing resources for funding the transition of primary care practices.