| Policy challenges in building the medical home: do we have a shared blueprint? | |
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MedLine Citation:
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PMID: 20453185 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The notion of a patient-centered medical home features prominently in policy reform initiatives across the country, with both state and federal legislation focusing on this new model. We sought to understand the views of key stakeholders and to examine the challenging landscape facing policymakers and practitioners as they attempt to translate the medical home concept into widespread practice change. METHODS: We reviewed legislative documents from state legislative sessions in the year 2007 to identify pieces of legislation that included the medical home concept. Concurrently we conducted an in-depth qualitative analysis of de-identified field notes from a purposeful sample of semistructured interviews conducted with key stakeholders in Oregon after the passage of health reform legislation in 2007. RESULTS: Legislation that further defined and expounded on the medical home concept was introduced in states across the country in 2007, and some federal and state demonstration projects were already underway. However, we identified a number of barriers to widespread implementation of the medical home, most notably lack of a clear operational definition. Key stakeholders had widely disparate views about elements central to the success of medical home demonstrations, including delivery system reform, payment reform, and performance incentives for providers. CONCLUSIONS: Since 2007 the concept of the medical home has gained increasing attention in health care reform debates. Our findings suggest that translating this concept into successful, widespread reform will require that policymakers build further consensus among key stakeholders and require them to address critical barriers to avoid repeating pitfalls of past reform efforts. |
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Authors:
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Robert J Stenger; Jennifer E Devoe |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of the American Board of Family Medicine : JABFM Volume: 23 ISSN: 1557-2625 ISO Abbreviation: J Am Board Fam Med Publication Date: 2010 May-Jun |
Date Detail:
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Created Date: 2010-05-10 Completed Date: 2011-01-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101256526 Medline TA: J Am Board Fam Med Country: United States |
Other Details:
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Languages: eng Pagination: 384-92 Citation Subset: IM |
Affiliation:
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Department of Family Medicine, Oregon Health and Science University, Portland, OR 97239, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Delivery of Health Care
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organization & administration Health Care Reform / legislation & jurisprudence, organization & administration* Health Expenditures Health Policy / trends Health Resources Humans Oregon Patient-Centered Care / methods Physician's Practice Patterns Primary Health Care / organization & administration* Qualitative Research |
| Grant Support | |
ID/Acronym/Agency:
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1-K08-HS16181/HS/AHRQ HHS; 5-F32-HS014645/HS/AHRQ HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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