title: Assessment and measurement of patient-centered medical home implementation: the BCBSM experience.
abstract: OBJECTIVE
  Our goal was to describe an approach to patient-centered medical home (PCMH) measurement based on delineating the desired properties of the measurement relative to assumptions about the PCMH and the uses of the measure by Blue Cross Blue Shield of Michigan (BCBSM) and health services researchers.
  
  
  METHODS
  We developed and validated an approach to assess 13 functional domains of PCMHs and 128 capabilities within those domains. A measure of PCMH implementation was constructed using data from the validated self-assessment and then tested on a large sample of primary care practices in Michigan.
  
  
  RESULTS
  Our results suggest that the measure adequately addresses the specific requirements and assumptions underlying the BCBSM PCMH program-ability to assess change in level of implementation; ability to compare across practices regardless of size, affiliation, or payer mix; and ability to assess implementation of the PCMH through different sequencing of capabilities and domains.
  
  
  CONCLUSIONS
  Our experience illustrates that approaches to measuring PCMH should be driven by the measures' intended use(s) and users, and that a one-size-fits-all approach may not be appropriate. Rather than promoting the BCBSM PCMH measure as the gold standard, our study highlights the challenges, strengths, and limitations of developing a standardized approach to PCMH measurement.
authors.affiliation: University of Michigan, School of Public Health, Department of Health Management and Policy, Ann Arbor, Michigan 48109-2029, USA. jalexand@umich.edu
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Alexander
authors.forename: Michael
authors.initials: M
authors.lastname: Paustian
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Wise
authors.forename: Lee A
authors.initials: LA
authors.lastname: Green
authors.forename: Michael D
authors.initials: MD
authors.lastname: Fetters
authors.forename: Margaret
authors.initials: M
authors.lastname: Mason
authors.forename: Darline K
authors.initials: DK
authors.lastname: El Reda
mesh_terms: D054598:Blue Cross Blue Shield Insurance Plans; D006801:Humans; D008824:Michigan; D009936:Organizational Innovation; D018802:Patient-Centered Care / Q000458:organization & administration / Q000592:standards*; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*
keywords: PCMH; PCMH assessment; measurement; patient-centered medical home; primary care; validity