Developing a policy-relevant research agenda for the patient-centered medical home: a focus on outcomes.
BACKGROUND
The Patient-Centered Medical Home (PCMH) is a widely endorsed model of delivery system reform that emphasizes primary care. Pilot demonstration projects are underway in many states, sponsored by Medicare, Medicaid, major health plans and multi-payer coalitions.


METHODS
In this paper we consider the development of a long-term policy-relevant research agenda on outcomes of the PCMH. We provide an overview of potential measures of PCMH impact, identify measurement challenges and recommend areas for further study. Although the PCMH should not be expected to solve every problem in the health care system, developing a research agenda for measuring outcomes of delivery system innovations such as the PCMH should be considered in the context of the larger effort to improve the US health care system, with the ultimate goal to improve population health.


RESULTS
As a framework for our discussion, we have chosen the Institute of Medicine's six specific aims for 21st century health care: (1) safe, (2) effective, (3) patient-centered, (4) timely, (5) efficient and (6) equitable. In addition, we include potential areas of PCMH outcomes that do not easily fall under this framework and consider unintended consequences.


CONCLUSIONS
Multi-stakeholder involvement will be essential in developing a long-term policy-relevant research agenda for outcomes of the PCMH.
Rittenhouse
Diane R
DR
Department of Family and Community Medicine, University of California, 500 Parnassus Avenue, MU 308-E, San Francisco, CA, USA. rittenhouse@fcm.ucsf.edu
Thom
David H
DH
Schmittdiel
Julie A
JA
D003695:Delivery of Health Care / Q000458:organization & administration*; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D012106:Research; D014481:United States
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