Patient-Centered Medical Home Among Small Urban Practices Serving Low-Income and Disadvantaged Patie

Authors, Primary Berry,Carolyn A.;Mijanovich,Tod;Albert,Stephanie;Winther,Chloe H.;Paul,Margaret M.;Ryan,Mandy Smith;McCullough,Colleen;Shih,Sarah C.
Title Primary Patient-Centered Medical Home Among Small Urban Practices Serving Low-Income and Disadvantaged Patients
Periodical Full Annals of Family Medicine
Pub Year 2013
Volume 11
issue Not Available
Start Page Not Available
Abstract PURPOSE: Research on the patient-centered medical home (PCMH) model and practice redesign has not focused on the unique challenges and strengths of very small primary care practices serving disadvantaged patient populations. We analyzed the practice characteristics, prior experiences, and dimensions of the PCMH model that exist in such practices participating in the Primary Care Information Project (PCIP) of the New York City Department of Mental Health and Hygiene. METHODS: We obtained descriptive data, focusing on PCMH, for 94 primary care practices with 5 or fewer clinicians serving high volumes of Medicaid and minority patient populations in New York City. Data included information extracted from PCIP administrative data and survey data collected specifically for this study. RESULTS: Survey results indicated substantial implementation of key aspects of the PCMH among small practices serving disadvantaged patient populations, despite considerable potential challenges to achieving PCMH implementation. Practices tended to use few formal mechanisms, such as formal care teams and designated care or case managers, but there was considerable evidence of use of informal team-based care and care coordination nonetheless. It appears that many of these practices achieved the spirit, if not the letter, of the law in terms of key dimensions of PCMH. CONCLUSIONS: Small practices can achieve important aspects of the PCMH model of primary care, often with informal rather than formal mechanisms and strategies. The use of flexible, less formal strategies is important to keep in mind when considering implementation and assessment of PCMH-like initiatives in small practices.
Publisher Annals of Family Medicine
Place of Publication Not Available
Author/Address Not Available
PubMed Link
Reference Type(s) Journal Article
Topic Tag(s) Defining/Evaluating/Qualifying a Medical Home;Disparities;Implementation
Special Population(s) Not Available
Case Study No
Commentary/Opinion Piece No
Historical Publication No
Key/Foundational Article No
Literature Review No
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Summary of Article Rating No