Objective: The patient-centered medical home (PCMH) is emerging as a key strategy to improve health outcomes, reduce total costs, and strengthen primary care, but a myriad of operational measures of the PCMH have emerged. In 2009, the state of Oregon convened a public, legislatively mandated committee charged with developing PCMH measures. We report on the process of, outcomes of, and lessons learned by this committee.Methods: The Oregon PCMH advisory committee was appointed by the director of the Oregon Department of Human Services and held 7 public meetings between October 2009 and February 2010. The committee engaged a diverse group of Oregon stakeholders, including a variety of practicing primary care physicians.Results: The committee developed a PCMH measurement framework, including 6 core attributes, 15 standards, and 27 individual measures. Key successes of the committee's work were to describe PCMH core attributes and functions in patient-centered language and to achieve consensus among a diverse group of stakeholders.Conclusions: Oregon's PCMH advisory committee engaged local stakeholders in a process that resulted in a shared PCMH measurement framework and addressed stakeholders' concerns. The state of Oregon now has implemented a PCMH program using the framework developed by the PCMH advisory committee. The Oregon experience demonstrates that a brief public process can be successful in producing meaningful consensus on PCMH roles and functions and advancing PCMH policy. The patient-centered medical home (PCMH) is a promising strategy to achieve the triple aim of improved health outcomes, better patient experiences, and reduced per-capita costs by strengthening primary care.1-4 Professional organizations representing US primary care physicians have developed 7 principles that outline the core elements of the PCMH: a personal physician, physiciandirected medical practice, whole-person orientation, coordination and integration of care, attention to quality and safety, enhanced access to care, and payment that appropriately recognizes the value of the PCMH. 5 Coalitions of insurers, employers, professional organizations, and others have endorsed these principles, leading to broad agreement about general concepts underlying the PCMH. 6 As the PCMH moves from concept to reality, many entities have developed detailed operational PCMH definitions and measurement strategies based on the needs of their particular stakeholders. [7][8][9][10][11] This diversity of operational definitions has led to a range of projects all bearing the same generic name "medical home." 2,4,12 This article was externally peer reviewed. The most widely used tools to measure attributes of a medical home are the PCMH recognition programs developed by the National Committee for Quality Assurance (NCQA). 3,8 The 2008 version of the NCQA criteria has been criticized for a variety of reasons: the administrative burden and expense required to achieve recognition, a failure to emphasize practice characteristics associated with short-term...
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