The patient-centered medical home solution to the cost-quality conundrum.

The U.S. healthcare system has been plagued by rising costs while achieving relatively poor-quality outcomes, and the situation continues to worsen. One solution is the patient-centered medical home (PCMH) model of primary care. This model focuses on care coordination and development of long-term physician-patient relationships that are expected to lead to better quality care and higher rates of patient satisfaction than have previously been achieved. Although the PCMH features a number of core principles, significant differences are seen across models. Three of the most prevalent models are those offered by the American Academy of Family Physicians, National Demonstration Project, and National Committee for Quality Assurance (NCQA). After analysis, the NCQA approach emerged as the recommended model due to its specificity and comprehensiveness. Research suggests that the PCMH, and specifically the NCQA model, can achieve both increases in quality and reductions in cost. However, this finding is tempered by the challenges inherent in implementation.