Primary Care Leaders\u27 Attitudes and Experiences of Transforming and Sustaining the Patient-Centered Medical Home Model in Small to Medium Sized Primary Care Practices

The patient-centered medical home (PCMH) model is the fastest-growing delivery system innovation in the United States. Its continued growth and success is dependent on its adoption by primary care providers, in particular those of small to medium sized practices which make up the bulk of primary care practices across the nation. Yet few prior studies explore the perceptions and experiences of these providers as they undergo the transformation process and how these attitudes influence the adoption of the PCMH model. This study explores those ideas through a mixed-methods analysis of eleven small to medium sized practices (ten full time equivalent providers or less) in Southeastern Pennsylvania that recently underwent PCMH transformation. Descriptive characteristics were first gathered from survey responses. Then, using a Grounded Theory approach, themes and concepts from follow-up interviews were identified in order to elaborate and clarify the survey responses, providing a detailed understanding of the activities and attitudes surrounding transformation. Eleven total themes emerged from the data, with the themes of Workforce Changes, Outcomes Measurement, and EMR Integration emphasized more than any other theme. Barriers such as time and financial constraint were identified as significant burdens to transformation, especially for the smaller practices. Based on the findings, while transformation to a PCMH was generally looked upon favorably, more research is needed to evaluate the perceptions of providers as they undergo transformation in order to better anticipate and address the challenges that lay ahead. Presentation: 19 minute