Journey to the Patient-Centered Medical Home: A Qualitative Analysis of the Experiences of Practices in the National Demonstration Project

I am most impressed by the authors' ability to convey key learnings in a limited number of words. As they state in the discussion, the need for change in mental models by physicians and in attention to adaptive reserve are the most important insights offered by this study. The authors also note that changing mental models will require attention to both motivation and ability, and will be best served by looking at individual, social, and structural strategies. Most practices feel they are doing OK if the finances are in order and there are relatively few patient complaints. That won't be good enough if we want to work towards the IHI triple aim of access, quality, and cost. Thanks for this impressive and helpful piece of work.

Competing interests:   None declared