Pennsylvania Health Care Quality Alliance > Patient-Centered Medical Home

Patient-Center Medical Home

The Patient-Centered Medical Home (PCMH) is a team-based model of care led by a personal, primary care physician who provides continuous and coordinated care throughout a patient's lifetime to maximize health outcomes. The PCMH model aims to improve primary care by focusing on the patient-doctor relationship and to strengthen this dynamic through a more comprehensive approach to patient care and more active patient involvement. The American Academy of Pediatrics (AAP) introduced the medical home concept in 1967, initially referring to a central location for archiving a child's medical record. In its 2007, the AAP expanded the medical home concept to include these operational characteristics: accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care.

What are the goals of the PCMH?

The Patient-Centered Medical Home (PCMH) looks to benefit patients, employers, health plans, and policymakers. In the long-term, PCMH aims to improve health outcomes, enhance the patient and provider experience of care, and reduce expensive, unnecessary hospital and emergency department utilization. It also allows a primary physician to connect patients with a small group of carefully selected specialists with whom the primary care practice actively coordinates in order to improve overall quality of care.

What are the benefits of a PCMH?

The benefits of the Patient-Centered Medical Home (PCMH) are far-reaching. Data demonstrates that PCMH leads to better health outcomes and better care, and at a better cost:

  • Patient-Physician Relationship - A personal physician leads a team at the practice level as they collectively take long-term responsibility for a patient's care. This approach to care provides the tools and resources necessary for a patient to self-manage chronic conditions, and is founded on trust and respect between the clinician, the patient, and their families.
  • Treating the Whole Patient - With the ability to monitor long-term health, physicians can provide appropriate care in any context: acute, preventative, ongoing, and end of life. This type of care allows physicians to conduct more frequent checkups; to initiate treatment measures before costly, last-minute emergency procedures are necessary; and to advise patients on preventative care based on environmental and genetic risk factors they may face.
  • Coordinated Care - PCMH promotes the facilitation between entities (specialty care, hospital, home health, nursing homes), allowing physicians to ensure that procedures are relevant and efficient.
  • Quality and Safety - Physicians in the practice accept accountability for continuous quality improvement through voluntary engagement in performance measurement and improvement. By doing so, they aim to improve the patient's quality of life.
  • Reducing Health Disparities - An orientation to primary care reduces the impact of socio-demographic and socio-economic disparities on health.

Who participates in the PCMH?

A Patient-Centered Medical Home (PCMH) is a health care setting that facilitates partnerships between individual patients and personal physicians. Any primary care medical practice, hospital, or clinic can be a PCMH, if it follows a certain set of principles:

  • A personal physician leads individual patient care.
  • The whole patient is treated to monitor lifelong health.
  • Care is coordinated between all areas of the health care system.
  • Physicians practice voluntary accountability to see improvements in quality and safety measurements.

Several organizations have developed programs that recognize and/or accredit various health care organizations as medical homes according to specified sets of standards. These include:

  • National Committee for Quality Assurance (NCQA)
  • URAC (formerly the Utilization Review Accreditation Commission)
  • Joint Commission
  • Accreditation Association for Ambulatory Health Care (AAAHC)

There are currently over 400 physician practices in the Commonwealth of Pennsylvania that are certified by the National Committee for Quality Assurance (NCQA) as patient-centered medical homes. To find a PCMH in Pennsylvania near you, click here.

For more information on the benefits of the patient-centered medical home model, please visit this website: