Pediatric Medical Homes: Laying the Foundation of a Promising Model of Care

In recent years the nation's health care system has accelerated the development and implementation of a new model of patient care -- the medical home. States, insurers, health care delivery systems, and individual practices are increasingly exploring ways to leverage medical homes to improve the quality of care and limit increases in health care costs. This Thrive report describes the current status of the medical home concept and explains how it has been broadly defined, applied to children, and measured. It also reports on the number and characteristics of American children served by medical homes and discusses opportunities to further leverage medical homes to improve medical care and achieve better health outcomes for young children, with a particular focus on the coordination of care for vulnerable children. The medical home concept builds on the foundations of primary care and managed care. Though the model is increasingly being recommended for all people, medical home implementation often prioritizes the goal of improving the quality and management of care for individuals with chronic disease or other critical health-impacting factors. Originally conceived by pediatricians over four decades ago, the medical home concept has become much more visible recently, particularly within the context of health care reform. The development of the medical home model of primary care can be traced back to the 1960s, but not until the 1990s did the advent of managed care prompt more focused exploration of potential payment models that could support broader implementation of medical homes. As a result, recent years have seen a high degree of activity around the definition, accreditation, and reimbursement of medical homes