Patient Centered Medical Home is a model of patient care that was first introduced by the American Academy of Pediatrics in 1967 and expanded in the late 2000s to include family practice and internal medicine physicians. The goal is to promote quality care that improves the health of the population, enhances the patient experience of care and controls or reduces the overall cost of health care. 

Benefits for the patient include:

  • Better coordinated, more comprehensive and personalized care
  • Improved access to medical care and services
  • Improved health outcomes, especially for patients who have chronic conditions 

Patients and the medical care team should experience:

  • Patients have access to a personal physician who leads the care team within a medical practice.
  • The care team provides comprehensive care, including acute care, chronic care, preventive services and end-of-life care, at all stages of life.
  • Practices take steps to ensure that patients receive the care and services they need from the medical neighborhood, in a culturally and linguistically appropriate manner.
  • Practices use the quality improvement process and evidence-based medicine to continually improve patient outcomes.
  • Practices commit to enhancing patients’ access to care. 

The five core attributes of the PCMH as defined by the Agency for Healthcare Research and Quality are:

  • Patient-centered: The PCMH supports patients in learning to manage and organize their own care based on their preferences, and ensures that patients, families, and caregivers are fully included in the development of their care plans. It also encourages them to participate in quality improvement, research, and health policy efforts.
  • Comprehensive: The PCMH offers whole-person care from a team of providers that is accountable for the patient’s physical and behavioral/mental health needs, including prevention and wellness, acute care, and chronic care.
  • Coordinated: The PCMH ensures that care is organized across all elements of the broader health care system, including specialty care, hospitals, home health care, community services, and long-term care supports.
  • Accessible: The PCMH delivers accessible services with shorter waiting times, enhanced in-person hours, 24/7 electronic or telephone access, and alternative methods of communication through health information technology (HIT).
  • Committed to Quality and Safety: The PCMH demonstrates commitment to quality improvement and the use of data and health information technology (HIT) and other tools to assist patients and families in making informed decisions about their health.