• The Medical Home

    Building a medical home requires hard work from you and your practice team. There are no shortcuts—change requires time, money, dedication, and sustained effort, and you will not see results overnight. Faced with these challenges, practice transformation may seem like a daunting prospect. But the need for change is real: Health care in the United States is moving away from a volume-based payment system and toward a value-based system. The effort you put into practice transformation will not only position you to better respond to the changing health care landscape but, with time, will also benefit your patients, your practice, and your bottom line.

    What Is a Medical Home?

    The American Academy of Family Physicians defines a medical home as one that is based on the Joint Principles of the Patient-Centered Medical Home (PCMH), the Shared Principles of Primary Care, and the five key functions of advanced primary care. Through implementing medical home functions, you can improve the quality, effectiveness, and efficiency of the care you deliver while responding to each patient’s unique needs and preferences.

    Five Key Functions of a Medical Home

    No matter where you fall on the spectrum of practice improvement—managing current projects, enhancing basic concepts, or advancing to more complex initiatives—adopting the five key functions of a medical home can benefit your practice, your patients, and your bottom line.


    Why Transform to a Medical Home?

    Benefits for Your Bottom Line

    • A more efficient use of practice resources, resulting in cost savings
    • A practice equipped to take advantage of payment incentives for adopting medical home functions
    • A practice that is better prepared for enhanced payment under MIPS or Alternative Payment Models (APMs)
    • A practice that is primed to participate in accountable care organizations

    Benefits for Your Patients

    • Better coordinated, more comprehensive, and personalized care
    • Improved access to medical care and services
    • Improved health outcomes, especially for patients who have chronic conditions

    Benefits for Your Practice

    • Increased physician and staff member well-being and satisfaction
    • Physicians and staff members who practice at the top of their licenses
    • Improved safety and quality of care

    Medical Homes and the Quality Payment Program (QPP)

    Medical Homes and the Quality Payment Program (QPP)
    The improvement activity (IA) category is a performance category in the QPP Merit-based Incentive Payment System (MIPS). It contains activities similar to the medical home functions. The IAs are designed to improve clinical practice or care delivery that, when effectively executed, lead to improved outcomes.

    • Eligible clinicians (EC) in a practice that has received PCMH recognition from the following organizations will automatically receive full credit for the MIPS IA category:
      National Committee on Quality Assurance (NCQA)
    • The Joint Commission (TJC)
    • URAC
    • Accreditation Association for Ambulatory Health Care (AAAHC)
    • Accrediting bodies that have certified 500 or more practices

    Practices and ECs will attest that they are a recognized PCMH. If there are multiple practices reporting under one tax identification number (TIN), at least 50 percent of practices within the TIN need to be recognized to automatically receive full credit.