What Is PCMH?

The intention of PCMH is to help make sense out of healthcare chaos and to give patients more control in their healthcare outcomes. The goal is also to help strengthen the relationship between physician and patient.

What does a recognized PCMH include?

  • A team approach
  • Improved access
  • Electronic Health Records
  • Better care coordination
  • Measuring quality care
  • Improved quality & safety

What Health IT domains are necessary for a successful PCMH model?

  • Telehealth
  • Measurement of quality and efficiency
  • Care transitions
  • Personal health records
  • Registries
  • Team care
  • Clinical decision support for chronic diseases

Is there proof that the PCMH model is effective?

According to the Patient-Centered Primary Care Collaborative (PCPCC), a care team of a primary care provider combined with pay-for-performance incentives is effective in improving overall healthcare quality, raising patient satisfaction, and expanding access to preventative care services.

  • Colorado Multi-Payer PCMH– 15% fewer ED visits, 18% fewer inpatient admissions, & ROI of 4.5 dollars for every dollar spent.
  • New York & New Jersey practices increased breast cancer screenings by up to 3.5% and boosted blood pressure control and A1c testing by 21% and 5%.
  • BCBS of AL achieved an estimated cost savings of $1.9 million.
  • CareFirst BCBS in Maryland reported a $98 million in total cost savings and brought quality scores for PCMH panels up by 9.3% in a year.

Why consider becoming a PCMH facility?

  • American families benefit from access to better coordinated care
  • Better patient outcomes and increased patient satisfaction
  • A better trained, more-engaged practice team
  • Shared responsibilities among team members
    and expanded team of specialists
  • Fewer visits to ER and more visits to primary care
  • Increased revenue potential

How to become recognized as a PCMH?

National Committee for Quality Assurance (NCQA) PCMH recognition is the most widely-used way to transform primary care practices into medical homes.

NCQA Physician Practice Connections and Patient Centered Medical Home (PPC-PCMH) Recognition Program emphasizes the systematic use of patient-centered, coordinated care management processes.


Additional Resources

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