Drivers of Change Among Patient-Centered Medical Home Practices
| Recognition Level | |||
|---|---|---|---|
| Change Driver | Overall (N=249) | Level 1 (n=91) | Level 3a (n=158) |
| Priority for “making practice more of a patient-centered medical home,”b % | 29.8 | 24.4 | 32.9 |
| Motivations for PCMH, mean (SD) ratingc | |||
| To improve quality of patient care | 4.4 (0.9) | 4.3 (1.0) | 4.4 (0.9) |
| To improve patient experiences of care | 4.4 (0.9) | 4.3 (1.3) | 4.4 (0.8) |
| To function more efficiently | 4.1 (1.2) | 4.1 (1.1) | 4.0 (1.2) |
| To become eligible for financial incentives | 4.0 (1.1) | 4.1 (1.1) | 3.9 (1.1) |
| To meet expectations/requirements set by our medical group or delivery system | 3.9 (1.2) | 4.0 (1.2) | 3.9 (1.3) |
| To improve clinician experience | 3.6 (1.3) | 3.5 (1.4) | 3.6 (1.3) |
| To meet expectations/requirements from my specialty society or board | 2.8 (1.5) | 3.0 (1.4) | 2.7 (1.5) |
| Barriers to PCMH implementation, mean (SD) ratingc | |||
| Timed | 3.7 (1.2) | 3.9 (1.2) | 3.6 (1.2) |
| Money and other resources to invest in staff, training, or equipmente | 3.3 (1.3) | 3.6 (1.3) | 3.1 (1.3) |
| Information systemsd | 2.7 (1.3) | 3.0 (1.4) | 2.5 (1.3) |
| Knowledge and experience | 2.5 (1.1) | 2.7 (1.2) | 2.4 (1.1) |
| Clinician/staff resistance to change | 2.4 (1.2) | 2.5 (1.2) | 2.3 (1.2) |
| Clinician/staff turnover | 1.9 (1.2) | 1.8 (1.3) | 2.0 (1.2) |
PCMH=patient-centered medical home.
Note: Pearson χ2 test for categorical variables and independent samples t tests for continuous variables.
↵a Includes practices that entered the study at Level 3 and practices that advanced from Level 1 to Level 3 during the study.
↵b Rating of 9 or 10 on scale of 0 to 10.
↵c Range: 1 to 5, with higher ratings indicating greater barrier.
↵d P <.05, difference by level.
↵e P <.01, difference by level.