RT Journal Article
SR Electronic
T1 Summary of the National Demonstration Project and Recommendations for the Patient-Centered Medical Home
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP S80
OP S90
DO 10.1370/afm.1107
VO 8
IS Suppl 1
A1 Benjamin F. Crabtree
A1 Paul A. Nutting
A1 William L. Miller
A1 Kurt C. Stange
A1 Elizabeth E. Stewart
A1 Carlos Roberto Jaén
YR 2010
UL http://www.annfammed.org/content/8/Suppl_1/S80.abstract
AB This article summarizes findings from the National Demonstration Project (NDP) and makes recommendations for policy makers and those implementing patient-centered medical homes (PCMHs) based on these findings and an understanding of diverse efforts to transform primary care. The NDP was launched in June 2006 as the first national test of a particular PCMH model in a diverse sample of 36 family practices, randomized to facilitated or self-directed groups. An independent evaluation team used a multimethod evaluation strategy, analyzing data from direct observation, depth interviews, e-mail streams, medical record audits, and patient and clinical staff surveys. Peer-reviewed manuscripts from the NDP provide answers to 4 key questions: (1) Can the NDP model be built? (2) What does it take to build the NDP model? (3) Does the NDP model make a difference in quality of care? and (4) Can the NDP model be widely disseminated? We find that although it is feasible to transform independent practices into the NDP conceptualization of a PCMH, this transformation requires tremendous effort and motivation, and benefits from external support. Most practices will need additional resources for this magnitude of transformation. Recommendations focus on the need for the PCMH model to continue to evolve, for delivery system reform, and for sufficient resources for implementing personal and practice development plans. In the meantime, we find that much can be done before larger health system reform.