Physician practices and readiness for medical home reforms

Abstract

"Objective: To determine the proportion of physician practices in the United States that currently meets medical home criteria.<br> Data Source/Study Setting: 2007 and 2008 National Ambulatory Medical Care Survey: Study Design: We mapped survey items to the National Committee on Quality Assurance's (NCQA's) medical home standards. After awarding points for each 'passed' element, we calculated a practice's infrastructure score, dividing its cumulative total by the number of available points. We identified practices that would be recognized as a medical home (Level 1: 25-49 percent, Level 2: 50-74 percent, or Level 3: infrastructure score >75 percent) and examined characteristics associated with NCQA recognition.<br> Results: Forty-six percent (95 percent confidence interval CI, 42.5-50.2) of all practices lack sufficient medical home infrastructure. While 72.3 percent (95 percent CI, 64.0-80.7 percent) of multi-specialty groups would achieve recognition, only 49.8 percent (95 percent CI, 45.2-54.5 percent) of solo/partnership practices meet NCQA standards. Although better prepared than specialists, 40 percent of primary care practices would not qualify as a medical home under present criteria.<br> Conclusion: Almost half of all practices fail to meet NCQA standards for medical home recognition." (Author's abstract, IAB-Doku) ((en))

Cite article

Hollingsworth, J., Saint, S., Sakshaug, J., Hayward, R., Zhang, L. & Miller, D. (2012): Physician practices and readiness for medical home reforms. Policy, pitfalls, and possibilities. In: Health Services Research, Vol. 47, No. 1 Part 2, p. 486-508. DOI:10.1111/j.1475-6773.2011.01332.x