Recommendations for a Mixed Methods Approach to Evaluating the Patient-Centered Medical Home

"Recommendations for a Mixed Methods Approach to Evaluating the Patient-Centered Medical Home" provides a much needed summary of tools aimed at measuring the success of the PCMH clinical model from multiple perspectives. Given that much evidence to date has focused on end transformation and not the journey, this mixed methods approach would appreciably fill in many missing gaps about how to effectively implement and scale the medical home model, and how and why transformation was successful within the context in which the PCMH model was implemented.

While the use of a standard approach to tracking transformation, such as the NCQA accreditation guidelines, is highly important since several incentive programs are tied to accreditation, limiting transformation to elements within those guidelines may hinder the ability to generate meaningful transformation (and subsequently identify factors that led to meaningful transformation) when conditions require deviating from the base accreditation model. Identifying and tracking these deviations may have significant value to achieving meaningful transformation in different contexts. It would be premature to definitively tie the success of PCMH to a single clinical model when the PCMH is still being defined and refined, and there is limited evidence of whether any one model outperforms others or in what contexts one model may be preferred over another. The mixed method evaluation framework proposed by the authors should help answer these questions, help refine the PCMH model and help further define success within the PCMH model.

Competing interests: None declared