Defining and Building a Patient-Centered Medical Home

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DESCRIPTION (provided by the applicant): In March 2007, professional societies representing primary care disciplines endorsed the "Joint Principles of the Patient-Centered Medical Home (PCMH)". Consequently, the National Committee for Quality Assurance developed a tool to recognize practices as PCMHs. The tool emphasizes practice structures with a strong emphasis on information technology. It is unclear that these practice structures are associated with the actual provision of primary care characteristics, the theoretical foundation of a PCMH, or patient outcomes. PURPOSE: This career development proposal will 1) examine the correlation between the PCMH recognition tool and a tool measuring the evidence-based features of primary care, and 2) identify the factors underlying each of the tools, and 3) assess the correlation between the PCMH recognition tool and a tool measuring the evidence-based features of primary care with clinical outcomes. This project will lead to an R01 application to develop an improved tool for PCMH recognition, incorporating elements of the original tool correlated with primary care and with improved clinical outcomes. CANDIDATE: The candidate is an assistant professor in a research position jointly appointed in the Department of Family Medicine and the Department of Pediatrics and Human Development at the Michigan State University College of Human Medicine. TRAINING GOALS: The goals of the training are to 1) gain didactic training in health services systems theories and practice and 2) apply the theories to applications of health services research to identify features of the current PCMH recognition tool correlated with evidence-based features of primary care and improved clinical outcomes. RESEARCH METHODS: The research methods include a correlation analysis of total scores of and domains in the NCQA PPC-PCMH and the PCAT tools, a factor analysis of each tool, and correlation of each tool with clinical outcomes at the practice level. OUTCOMES: The outcomes include a greater understanding of the correlation of PCMH recognition tool with primary care attributes and the relationship of each to improved clinical outcomes. BENEFIT: The results will be used to develop policy to appropriately classify practices as PCMHs and to inform reimbursement strategies for PCMHs based on patient outcomes. The work resulting from this study will provide an understanding of the correlation between the current tool intended to recognize clinical practices at patient-centered medical homes (PCMHs) and the evidenced-based features of primary care and patient outcomes. The results will inform policymakers on the utility of the current PCMH recognition tool in appropriately classifying practices as PCMHs and inform payers on the utility of the current tool in identifying practices with better patient outcomes