The patient-centered medical home: history, components, and review of the evidence.
The US healthcare system is plagued by unsustainable costs and yields suboptimal outcomes, indicating that new models of healthcare delivery are needed. The patient-centered medical home is one model that is increasingly regarded as a promising strategy for improving healthcare quality, decreasing cost, and enhancing the experience of both patients and providers. Conceptually, the patient-centered medical home may be described as combination of the core attributes of primary care-access, continuity, comprehensiveness, and coordination of care-with new approaches to healthcare delivery, including office practice innovations and reimbursement reform. Implementation efforts are gaining momentum across the country, fueled by both private-payer initiatives as well as supportive public policy. High-quality evidence on the effectiveness of the patient-centered medical home is limited, but the data suggest that, under some circumstances, patient-centered medical home interventions may lead to improved outcomes and generate moderate cost savings. Although the patient-centered medical home enjoys broad support by multiple stakeholders, significant challenges to widespread adoption of the model remain.
Mount Sinai School of Medicine, New York, NY, USA. jonathan.arend@mountsinai.org
Jonathan
J
Arend
Jenny
J
Tsang-Quinn
Claudia
C
Levine
David
D
Thomas
D002908:Chronic Disease; D003695:Delivery of Health Care / Q000458:organization & administration*; D057286:Electronic Health Records; D019317:Evidence-Based Medicine; D018166:Health Care Reform; D006297:Health Services Accessibility; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D018802:Patient-Centered Care / Q000266:history / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D012051:Reimbursement Mechanisms; D014481:United States