In recent years, the American Academy of Pediatrics, the American Academy of Family Physicians (AAFP), and others have promoted a patient-centered practice model" the patient-centered medical home (PCMH) "that delivers patient-centered, physician-guided, cost-efficient, longitudinal care. The 2006 Practice Profile Survey of the AAFP showed considerable variation in adoption of services seen as part of a PCMH, from 12% who use web-based consults or e-visits to 24% who use registries or patient tracking systems to 41% who use electronic medical records to 47% who use chronic disease management. Rural practices will need to meet the expectations inherent in the PCMH model or lose any payment advantage that comes with participating as a PCMH. The goal of this project is to assess rural readiness to adopt services seen as part of a PCMH.

We will analyze questions relevant to the PCMH formation from national surveys and compare the use of various elements of electronic medical records among different categories of rural practices, between urban and rural practices, and among practices with different payer mix. We will design a readiness assessment tool and pilot test the tool with two randomly selected rural primary care practices in each of the nine census divisions. Products will include a policy brief and an issue paper.

Publications

• Are Primary Care Practices Ready to Become Patient-Centered Medical Homes?
  Journal Article
  RUPRI Center for Rural Health Policy Analysis
  Date: 2013
  Measures the readiness of rural primary care practices to be eligible as patient-centered medical homes (PCMHs) by comparing PCMH readiness scores with metropolitan and nonmetropolitan primary care practices.
• Patient-Centered Medical Home Services in 29 Rural Primary Care Practices: A Work in Progress
  RUPRI Center for Rural Health Policy Analysis
  Date: 09/2011
  This brief discusses responses from 29 rural physician practices. When asked about the use of specific policies/procedures included as criteria to certify patient-centered medical homes, fewer of them would qualify in each of five domains, including access to care, population-based, quality, care management, and clinical information management.
• Use of Health Information Technology in Support of Patient-Centered Medical Homes Is Low Among Non-Metropolitan Family Medicine Practices
  RUPRI Center for Rural Health Policy Analysis
  Date: 04/2011
  Are physician practices, especially non-metropolitan primary care practices, ready to become patient-centered medical homes? We use a nationwide survey of physician practices to partially answer this question, focusing on the use of health information technology.