Up to this point, patient-centered medical homes have been recognized and rewarded mostly by measuring practice capabilities, rather than by assessing whether care is actually patient-centered. In fact, the first national test of the model revealed that patients' perceptions of care worsened slightly while providers were consumed with transforming their practices into medical homes.

But a new report funded by the Robert Wood Johnson Foundation reveals that infrastructure and health IT alone won't be enough to be recognized and reimbursed as a medical home for long, as most certifying bodies have plans in the works to better measure patient-centeredness.

For example, the National Committee for Quality Assurance (NCQA) has announced that, starting in 2012, it will award practices extra "distinction" if they voluntarily survey their patients on their care experience. And the Joint Commission, which more recently entered the medical-home recognition fray, will require practices to collect this data to obtain medical home distinction, according to the report.

The authors also point out that the Affordable Care Act's Shared Savings Program, which calls for the formation of accountable care organizations (ACO) to coordinate care for a panel of Medicare beneficiaries, implicitly relies on many aspects of the medical home model. Thus, it's important to note that the Centers for Medicare & Medicaid Services (CMS) has proposed basing payments to ACOs in part on patient experience survey results. CMS has also listed eight patient-centeredness capabilities that ACOs will need to possess to participate in Medicare's ACO program.

Although there is, to date, little consensus on the definition of a medical home or evidence as to what features of the model truly improve care, the idea of making care more patient-centered will only continue to gain ground. So while practices may have difficulty raising capital to implement changes to be officially recognized as medical homes, their resources are well spent in seeking ways to improve the patient experience.

To learn more:
- read the article from the Connecticut Mirror
- here's the report from the Robert Wood Johnson Foundation and the Urban Institute

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