title: Patient experience over time in patient-centered medical homes.
abstract: OBJECTIVE
  Although the Patient-Centered Medical Home (PCMH) model is being implemented across the country to transform primary care, it is not yet clear whether this model actually improves patients' experiences with healthcare. Our objective was to measure patients' experiences over time in practices that transformed into PCMHs.
  
  
  METHODS
  We conducted a prospective study, using 2 serial cross-sectional samples, in a multipayer community.
  
  
  METHODS
  We surveyed 715 patients: 346 at baseline, when practices had just completed transformation, and 369 at follow-up, which was a median of 15 months later. These patients received care from 120 primary care providers at 10 ambulatory practices (20 sites) that achieved Level III PCMH, as defined by the National Committee for Quality Assurance. We measured patient experience, as defined by the 7 domains of the Clinician and Group-Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) Adult Primary Care Questionnaire.
  
  
  RESULTS
  Patients' self-reported experience with access to care improved significantly over time, with 61% of respondents giving access to care the highest rating at baseline versus 69% at follow-up (P = .02). There were no significant changes over time for the other domains.
  
  
  CONCLUSIONS
  The PCMH was associated with improvements in patients' experience with access to care but not other domains of care. This study, which took place in a multi-payer community, is one of the first to find a positive effect of the PCMH on patient experience.
authors.affiliation: Department of Public Health, Weill Cornell Medical College, 425 E 61st St, New York, NY 10065, USA. lmk2003@med.cornell.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kern
authors.forename: Rina V
authors.initials: RV
authors.lastname: Dhopeshwarkar
authors.forename: Alison
authors.initials: A
authors.lastname: Edwards
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011446:Prospective Studies; D014481:United States