Summary of Key Stakeholder Perspectives on Medical Home Principles
| Primary Care Providers | Clinic and Health System Administrators | Insurers and Payers | Policymakers | |
|---|---|---|---|---|
| Personal physician | Familiar concept Highly valued | Familiar concept Not highly valued | Familiar concept Not highly valued | Familiar concept Somewhat valued |
| Physician-directed medical practice | Foreign concept May be reluctant to participate in team-based care | Good understanding of team dynamics and differing roles of primary care team members | Very limited understanding of team-based primary care | Very limited understanding of primary care teams and roles |
| Whole-person orientation | Familiar concept Important core value of primary care | Limited understanding of concept Not highly valued | Limited understanding of concept Not highly valued | Some understanding of concept Somewhat valued |
| Care is coordinated and/or integrated | Limited understanding of care coordination strategies (patient-level focus) Sometimes part of current practice Variable understanding | Limited understanding of care coordination strategies (systems-level focus) Some understanding | Some understanding of concept May not link care coordination to the medical home (caved out services) Highly valued | Some understanding of concept Limited understanding of quality improvement Not valued |
| Quality and safety | Variable desire to participate in new projects Skeptical of new requirements/oversight | Importance driven by regulatory and licensure requirements | Favor tighter regulation and oversight of primary care to improve quality and safety | Highly valued (regulatory mindset) |
| Enhanced access | Well understood Limited support because of overwork of providers in current system | Well understood Customer-service mentality | Well understood (emphasis on customer service and costs) May not link to medical home | Well understood Somewhat valued |
| Payment | Very highly valued, of critical importance Skeptical of pay-for-performance | Very highly valued, of critical importance Skeptical of new payment methodologies | Very sensitive to rising health care costs Likely to demand proof of value/cost savings | Extremely sensitive to overall system costs and impact on health care budgets Supportive of demonstrations |