title: Physician Perspectives on Medical Home Recognition for Practice Transformation for Children.
abstract: To examine child-serving physicians' perspectives on motivations for and support for practices in seeking patient-centered medical home (PCMH) recognition, changes in practice infrastructure, and care processes before and after recognition, and perceived benefits and challenges of functioning as a PCMH for the children they serve, especially children with special health care needs.
  
  
  
  Semistructured interviews with 20 pediatricians and family physicians at practices that achieved National Committee for Quality Assurance level 3 PCMH recognition before 2011. We coded notes and identified themes using an iterative process and pattern recognition analysis.
  
  
  
  Physicians reported being motivated to seek PCMH recognition by a combination of altruistic and practical goals. Most said recognition acknowledged existing practice characteristics, but encouraged ongoing, and in some cases substantial, transformation. Although many physicians said recognition helped practices improve financial arrangements with payers and participate in quality initiatives, most physicians could not assess the specific benefits of recognition on patients' use of services or health outcomes. Challenges for practices in providing care for children included managing additional physician responsibilities, communicating with other providers and health systems, and building sustainable care coordination procedures.
  
  
  
  PCMH recognition can be valuable to practices as a public acknowledgement to payers and patients that certain processes are in place, and can also catalyze new and continued transformation. Programs and policies seeking to transform primary care for children should leverage physicians' motivations and find mechanisms to build practices' capacity for care management systems and linkages with the medical neighborhood.
authors.affiliation: Mathematica Policy Research, Health Research Division, Oakland, Calif. Electronic address: dpetersen@mathematica-mpr.com.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Petersen
authors.affiliation: Mathematica Policy Research, Health Research Division, Ann Arbor, Mich.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zickafoose
authors.affiliation: Mathematica Policy Research, Health Research Division, Ann Arbor, Mich.
authors.forename: Mynti
authors.initials: M
authors.lastname: Hossain
authors.affiliation: Mathematica Policy Research, Health Research Division, Washington DC.
authors.forename: Henry
authors.initials: H
authors.lastname: Ireys
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D018802:Patient-Centered Care / Q000592:standards*; D000072143:Pediatricians; D010821:Physicians, Family; D011320:Primary Health Care / Q000592:standards*; D058996:Quality Improvement; D011787:Quality of Health Care
keywords: child health; medical home recognition; patient-centered medical home; practice transformation; primary care