The Policy Context of Patient Centered Medical Homes: Perspectives of Primary Care Providers

Authors, Primary Alexander,Jeffrey;Cohen,Genna;Wise,Christopher;Green,Lee
Title Primary The Policy Context of Patient Centered Medical Homes: Perspectives of Primary Care Providers
Periodical Full Journal of General Internal Medicine
Pub Year 2013
Volume 28
issue 1
Start Page 147-153
Abstract BACKGROUND: Interest in the patient centered medical home (PCMH) model has increased significantly in recent years. Despite this attention, information is limited regarding the influence of policy context on implementation of the PCMH model. Using comparative, qualitative data, we identify several key policy impediments to PCMH implementation, and propose practical guidelines for addressing these issues. RESEARCH DESIGN: Qualitative, semi-structured in-person interviews with representatives of physician organizations and primary care practices pursuing PCMH. PARTICIPANTS: Practitioners and staff at 16 physician practices in Michigan, as well as key leaders of physician organizations. KEY RESULTS: We identified five primary policy issues cited by physicians and physician organization leaders as most impactful on their efforts to adopt PCMH: misalignment of current reimbursement schemes, administrative burden, conflicting criteria for PCMH designation, workforce policy issues, and uncertainty of health care reform. These policies were largely seen as barriers to their ability to implement PCMH. CONCLUSIONS: Providers' motivation to embrace PCMH, and their level of confidence regarding the results of such change, are greatly influenced by their perception of the external environment and the control they believe they have over this environment. Having policies in place that shape the path to PCMH in a manner that makes it as easy as possible for providers to accomplish the desired changes could well make the difference in whether successful transformation is achieved.
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Reference Type(s) Journal Article
Topic Tag(s) Cost and Reimbursement;Primary Care Workforce Issues;Defining/Evaluating/Qualifying a Medical Home;Policy Issues;Implementation
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