Headline

The Patient-Centered Medical Home model shows positive impacts in health center settings including improved quality of care.

Context

The Patient-Centered Medical Home (PCMH) is an evidence-based model that addresses gaps in health care quality by redesigning health care infrastructure, particularly in primary care settings. The Health Resources & Services Administration (HRSA) has provided technical assistance and incentives to health centers to achieve PCMH recognition, which has resulted in several improvements in care processes. However, there is a gap in the literature on what systemic and/or infrastructure changes HCs make to achieve successful improvements in care processes. This study examines the changes in staffing infrastructure across health centers both before and after achieving PCMH status, as well as the related impacts on health outcomes.

Findings

The authors examined two measures of staffing infrastructure (team-based and multidisciplinary staff ratios) across three cohorts of health centers before and after PCMH recognition. The authors found moderate evidence that staff ratios among both measures of staffing infrastructures continued to grow long-term amongst all three cohorts. The growth and addition of staff including advance practice providers, allied health professionals, and nonclinical support staff may have supported PCPs to focus on more complex patients, allow for a more holistic approach to managing patients with chronic conditions, and link patients to social service providers – increasing quality of care overall.

Takeaways

Growth in team-based and multidisciplinary staff ratios, prompted by PCMH recognition, may be attributed to the increased promotion of whole-person care by PCMH recognized organizations. Additional HRSA funding and technical assistance provided to health centers also improved staffing infrastructures. The PCMH model has been widely adopted across health centers and has shown positive impacts on care processes and overall patient outcomes within these settings.