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Research ArticleOriginal Research

Medical Home Implementation in Small Primary Care Practices: Provider Perspectives

Gilbert Gimm, Jay Want, Dan Hough, Treniese Polk, Margaret Rodan and Len M. Nichols
The Journal of the American Board of Family Medicine November 2016, 29 (6) 767-774; DOI: https://doi.org/10.3122/jabfm.2016.06.160077
Gilbert Gimm
From the Department of Health Administration and Policy, Center for Health Policy Research and Ethics, and School of Nursing, George Mason University, Fairfax, VA (GG, TP, MR, LMN); the Center for Improving Value in Health Care, Denver, CO (JW); and Alan Newman Research, Richmond, VA (DH).
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Jay Want
From the Department of Health Administration and Policy, Center for Health Policy Research and Ethics, and School of Nursing, George Mason University, Fairfax, VA (GG, TP, MR, LMN); the Center for Improving Value in Health Care, Denver, CO (JW); and Alan Newman Research, Richmond, VA (DH).
MD
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Dan Hough
From the Department of Health Administration and Policy, Center for Health Policy Research and Ethics, and School of Nursing, George Mason University, Fairfax, VA (GG, TP, MR, LMN); the Center for Improving Value in Health Care, Denver, CO (JW); and Alan Newman Research, Richmond, VA (DH).
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Treniese Polk
From the Department of Health Administration and Policy, Center for Health Policy Research and Ethics, and School of Nursing, George Mason University, Fairfax, VA (GG, TP, MR, LMN); the Center for Improving Value in Health Care, Denver, CO (JW); and Alan Newman Research, Richmond, VA (DH).
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Margaret Rodan
From the Department of Health Administration and Policy, Center for Health Policy Research and Ethics, and School of Nursing, George Mason University, Fairfax, VA (GG, TP, MR, LMN); the Center for Improving Value in Health Care, Denver, CO (JW); and Alan Newman Research, Richmond, VA (DH).
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Len M. Nichols
From the Department of Health Administration and Policy, Center for Health Policy Research and Ethics, and School of Nursing, George Mason University, Fairfax, VA (GG, TP, MR, LMN); the Center for Improving Value in Health Care, Denver, CO (JW); and Alan Newman Research, Richmond, VA (DH).
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    Table 1.

    Summary of Patient-Centered Medical Home Requirements

    1.PCPs and NPs are required to be in good standing in CareFirst's regional PPO and HMO networks, abide by program rules (in Program Description and Guidelines), form or become part of a medical care panel, and become engaged in the care coordination activities at the heart of the program.
    2.A PCP is eligible for the PCMH program if he or she is a health care provider who is full time, a duly licensed medical practitioner, is a participating provider, and contracted to render primary care services in both the CareFirst BlueChoice Participating Provider Network (HMO) and the CareFirst Regional Participating Network and has a primary specialty in on the following: internal medicine, family practice, general practice, pediatrics, geriatrics, family practice/geriatric medicine, osteopathic medicine (primary care), or NPs (primary care).
    3.All PCPs in a group practice must join the program or none are accepted.
    4.Panels must contain at least a minimum of 5 PCPs and/or NPs.
    5.Practices may not participate in another PCMH during the time of CareFirst PCMH participation if both programs provide fees or incentives to the practice or CareFirst member.
    • HMO, health maintenance organization; NP, nurse practitioner; PCMH, patient-centered medical home; PCP, Primary care physician; PPO, preferred provider organization.

    • View popup
    Table 2.

    Descriptive Characteristics of CareFirst Patient-Centered Medical Home Panels

    Panel NumberPanel Type and PracticesProviders (n)Service Area
    1Multiple independent (medium to large practices)14Virginia
    2Health system practice13Maryland
    3Virtual (small practices)15Maryland
    4Multiple independent (medium to large practices)14Maryland
    5Health system practice9Maryland
    6Virtual (small practices)12Maryland
    7Single independent (medium practices)7Maryland
    8Health system practice15Virginia
    9Virtual (small practices)10Virginia
    10Single independent (medium practices)9Maryland
    11Single independent (medium practices)9Virginia
    12Multiple independent (medium to large practices)10Virginia
    13Virtual (small practices)12Maryland
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The Journal of the American Board of Family     Medicine: 29 (6)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 6
November-December 2016
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Medical Home Implementation in Small Primary Care Practices: Provider Perspectives
Gilbert Gimm, Jay Want, Dan Hough, Treniese Polk, Margaret Rodan, Len M. Nichols
The Journal of the American Board of Family Medicine Nov 2016, 29 (6) 767-774; DOI: 10.3122/jabfm.2016.06.160077

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Medical Home Implementation in Small Primary Care Practices: Provider Perspectives
Gilbert Gimm, Jay Want, Dan Hough, Treniese Polk, Margaret Rodan, Len M. Nichols
The Journal of the American Board of Family Medicine Nov 2016, 29 (6) 767-774; DOI: 10.3122/jabfm.2016.06.160077
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