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Patient-Centered Medical Home

This health care model improves outcomes and lowers costs by developing ongoing relationships between the:

  • Patient
  • Patient's family
  • Primary care provider (PCP)

Evidence shows the PCMH model improves care quality, patient satisfaction and total cost through preventive measures and chronic and acute condition management.

PCMH attributes

While standards vary slightly between accrediting organizations, the common attributes and goals are all in alignment with the core standards of PCMH below.

Patient-centered
Patients and/or family are:

  • Included in decision-making to accommodate unique needs and preferences
  • Encouraged to get involved in improving care quality throughout the organization

Comprehensive
PCMH uses a whole-person approach to delivering care. The PCP team:

  • Is accountable for the patient's entire well-being, including physical, mental and emotional health
  • Provides comprehensive care at all stages of life, offering preventive and behavioral health services, acute and chronic care, and end-of-life care

Coordinated
When appropriate, the PCP team coordinates care with other providers, i.e., safe transitions between hospitals, nursing homes and community health agencies.

Accessible
PCMHs are committed to:

  • Increasing access to care
  • Being available and accessible when patients need care
  • Urgent care availability
  • Alternative methods of communication
  • 24/7 access to someone on the PCP team

Commitment to quality and safety
The PCMH model of care is committed to ongoing improvement in:

  • Quality
  • Patient safety
  • Processes
  • Health information technology
  • Evidence-based medicine

National Organizations Certification Options

  • The Joint Commission
  • NCQA
  • Health Care Homes, Minnesota Dept. of Health