Summary of the National Demonstration Project and Recommendations for the Patient-Centered Medical Home

Abstract 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 lau...

Full description

Saved in:

Bibliographic Details
Published in:	Annals of family medicine Vol. 8; no. Suppl_1; pp. S80 - S90
Main Authors:	Crabtree, Benjamin F., PhD, Nutting, Paul A., MD, MSPH, Miller, William L., MD, MA, Stange, Kurt C., MD, PhD, Stewart, Elizabeth E., PhD, Jaén, Carlos Roberto, MD, PhD
Format:	Journal Article
Language:	English
Published:	United States American Academy of Family Physicians 2010
Subjects:	Evidence-Based Practice Family Practice - organization & administration Family Practice - standards Family Practice - trends Humans Internal Medicine Models, Organizational Organizational Innovation Outcome and Process Assessment (Health Care) Patient-Centered Care - organization & administration Patient-Centered Care - standards Patient-Centered Care - trends Quality Assurance, Health Care - methods Quality Assurance, Health Care - organization & administration Quality Assurance, Health Care - standards Summary United States United States organizational change National Demonstration Project family practice patient-centered care quality improvement practice-based research patient-centered medical home Primary care
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Abstract 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Disclaimer: The views presented here are those of the authors and not necessarily those of The Commonwealth Fund, its directors, officers, or staff. Dr Stange’s time was supported in part by a Clinical Research Professorship from the American Cancer Society. Disclaimer: Drs Stange and Nutting, who are editors of the Annals, were not involved in the editorial evaluation of or decision to publish this article. Funding support: The independent evaluation of the National Demonstration Project (NDP) practices was supported by the American Academy of Family Physicians (AAFP) and The Commonwealth Fund. The Commonwealth Fund is a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. Conflicts of interest: The authors’ funding partially supports their time devoted to the evaluation, but they have no financial stake in the outcome. The authors’ agreement with the funders gives them complete independence in conducting the evaluation and allows them to publish the findings without prior review by the funders. The authors have full access to and control of study data. The funders had no role in writing or submitting the manuscript. Publication of the journal supplement is supported by the American Academy of Family Physicians Foundation, the Society of Teachers of Family Medicine Foundation, the American Board of Family Medicine Foundation, and The Commonwealth Fund.
ISSN:	1544-1709 1544-1717
DOI:	10.1370/afm.1107