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Research ArticleOriginal Research

The Patient-Centered Medical Home (PCMH) Framing Typology for Understanding the Structure, Function, and Outcomes of PCMHs

Autumn M. Kieber-Emmons and William L. Miller
The Journal of the American Board of Family Medicine July 2017, 30 (4) 472-479; DOI: https://doi.org/10.3122/jabfm.2017.04.170058
Autumn M. Kieber-Emmons
the Lehigh Valley Health Network, Allentown, PA; and the Department of Family Medicine, University of South Florida Morsani College of Medicine, Tampa.
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William L. Miller
the Lehigh Valley Health Network, Allentown, PA; and the Department of Family Medicine, University of South Florida Morsani College of Medicine, Tampa.
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Abstract

Introduction: Patient-centered medical homes (PCHMs) aspire to transform today's challenged primary care services. However, it is unclear which PCMH characteristics produce specific outcomes of interest for care delivery. This study tested a novel typology of PCMH practice transformation, the PCMH framing typology, and evaluated measurable outcomes by each type.

Methods: Using the Patient-Centered Primary Care Collaborative 2012 to 2013 Annual Review, this secondary analysis of the published PCMH literature extracted data from publications of 59 PCMHs. Each of the 59 sites was categorized as 1 of 4 PCMH types: add-on, renovated, hybrid, or integrated. Six outcome measures (cost reductions, decreased emergency department/hospital utilization, improved quality, improved access, increased preventive services, and improved patient satisfaction) were independently coded for each site. Practices were combined based on type, and mean outcomes scores for each measure were displayed on radar graphs for comparison.

Results: While each type showed a characteristic pattern of success, only the integrated type improved in all 6 outcomes. No type achieved high success in all measures.

Discussion: There seem to be 4 types of PCMH, each of which shows a distinctive outcomes profile. Within the PCMH framing typology, direction is emerging for how best to transform primary care to achieve the greatest success.

  • Medical Home
  • Outcome Assessment (Health Care)
  • Patient Satisfaction
  • Patient-Centered Care
  • Primary Health Care
  • Process Assessment (Health Care)
  • Quality Improvement
  • Quality of Health Care
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The Journal of the American Board of Family     Medicine: 30 (4)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 4
July-August 2017
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The Patient-Centered Medical Home (PCMH) Framing Typology for Understanding the Structure, Function, and Outcomes of PCMHs
Autumn M. Kieber-Emmons, William L. Miller
The Journal of the American Board of Family Medicine Jul 2017, 30 (4) 472-479; DOI: 10.3122/jabfm.2017.04.170058

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The Patient-Centered Medical Home (PCMH) Framing Typology for Understanding the Structure, Function, and Outcomes of PCMHs
Autumn M. Kieber-Emmons, William L. Miller
The Journal of the American Board of Family Medicine Jul 2017, 30 (4) 472-479; DOI: 10.3122/jabfm.2017.04.170058
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Keywords

  • Medical Home
  • Outcome Assessment (Health Care)
  • Patient Satisfaction
  • Patient-Centered Care
  • Primary Health Care
  • Process Assessment (Health Care)
  • Quality Improvement
  • Quality of Health Care

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