Patient Centered Medical Home: A Journey Not a Destination

The Patient-Centered Medical Home (PCMH) is proposed as a vehicle to deliver primary health care to older adults. The PCMH has the ability to improve the quality of care and reduce unnecessary expenditures while fostering functional independence and improving quality of life. Steps to develop a PCMH for older adults include clarity of purpose, team building, process improvement, setting time for reflection and course adjustment, defining accountability, providing a supportive and safe work environment, fully utilizing capabilities of the electronic health record and building relationships with external community partners. Building and maintaining a PCMH requires payment changes in the form of blended or direct primary care payments. Some organizational structures beyond the PCMH can hinder development of the PCMH by excessive standardization and micromanaging or they can facilitate development by providing appropriate support with facilitative leadership. The PCMH is a journey, not a destination and requires ongoing evolution of medical models and attention to patient preferences