Transforming physician practices to patient-centered medical homes: Lessons from the national demonstration project

Paul A. Nutting, Benjamin F. Crabtree, William L. Miller, Kurt C. Stange, Elizabeth Stewart, Carlos Jaén

Research output: Contribution to journalArticle

216 Scopus citations

Abstract

Many commentators view the conversion of small, independent primary care practices into patient-centered medical homes as a vital step in creating a better-performing health care system. The country's first national medical home demonstration, which ran from June 1, 2006, to May 31, 2008, and involved thirty-six practices, showed that this transformation can be lengthy and complex. Among other features, the transformation process requires an internal capability for organizational learning and development; changes in the way primary care clinicians think about themselves and their relationships with patients as well as other clinicians on the care team; and awareness on the part of primary care clinicians that they will need to make long-term commitments to change that may require three to five years of external assistance. Additionally, transforming primary care requires synchronizing practice redesign with development of the health care "neighborhood," which is made up of a broad range of health and health care resources available to patients. It also requires payment reform that supports practice development and a policy environment that sets reasonable expectations and time frames for the adoption of appropriate innovations.

Original languageEnglish (US)
Pages (from-to)439-445
Number of pages7
JournalHealth Affairs
Volume30
Issue number3
DOIs
StatePublished - Mar 2011

ASJC Scopus subject areas

  • Health Policy

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