This library of publicly available resources and tools can help safety net providers understand and implement the patient-centered medical home (PCMH) model of care. Users can navigate these free resources by type or topic or by the registry of tools and resources, which includes all resources and tools hosted on the Web site and those hyperlinked within documents on the site.
Resource types include the following:
- PCMH assessment
- Change concept resources:...
The Practice Facilitation Handbook is designed to assist in the training of new practice facilitators as they begin to develop the knowledge and skills needed to support meaningful improvement in primary care practices. It evolved from the Agency for Healthcare Research and Quality's Integrating Chronic Care and Business Strategies in the Safety Net toolkit. That toolkit was developed to aid safety net practices in implementing the Chronic Care Model, now commonly referred to as the...
This operational handbook for safety-net medical homes describes the experience of Doctors Care, a community-funded, nonprofit organization that helps underserved children, adults, and families receive the medical attention they need. The handbook can help program managers maximize health care for the uninsured without overwhelming participating doctors, while also managing patient expectations.
It is organized into the following sections:
- Doctors Care History:...
This guide for families provides practical information about integrated care and how this approach can improve the quality of care children receive in pediatric primary care settings. The guide defines integrated care, outlines the benefits of this approach to care delivery, and explains how the approach works in a medical home setting.
Topics covered include the following:
- Integrated care: what is it?
- At a glance: steps to integrated care
The Primary Care–Specialty Care Compact was developed by the Systems of Care/Patient-Centered Medical Home Initiative, which seeks to improve systems of care by supporting physicians in becoming medical homes and working with specialists to uplink medical homes into integrated medical neighborhoods. The purpose of the compact is to improve care and build and sustain trusted medical neighborhoods through a defined communication protocol. It specifies key areas of a mutual care management...
This Web page from the American College of Physicians (ACP) provides resources to help further develop the Patient-Centered Medical Home (PCMH) model to integrate with specialty and subspecialty practices.
This model development is being addressed by the Council of Specialty Societies PCMH Workgroup and through collaborative initiatives between ACP and various specialty and subspecialty societies.
Resources include the following:
- ACP position paper...
This guide offers advice and interventions that practices can use to help their patients reduce avoidable emergency department visits. It covers the following topics:
- Educating patients on appropriate use
- Enhancing access to the primary care practice
- Improving care coordination and care transitions
This Web site from the American Academy of Family Physicians provides step-by-step project plans and tools to build a patient-centered medical home. It also includes a checklist for practices to determine if they are already a patient-centered medical home.
The Web site is divided into the following sections:
- Practice organization
- Health information technology
- Quality care
- Patient-centered care
The Patient Centered Medical Home (PCMH) Resource Center provides policymakers and researchers with access to evidence-based resources about the medical home and its potential to transform primary care and improve the quality, safety, efficiency, and effectiveness of U.S. health care. This Web site is organized into the following sections:
- Defining the PCMH
- Evidence and evaluation
- Tools and resources
- Implementing the PCMH
- Federal PCMH activities...
This guide for payers, plans, provider groups, patient advocacy groups, and all medication therapy management service providers discusses the rationale for including comprehensive medication management services in integrated patient-centered care. It provides the key steps necessary to promote best practices and achieve meaningful quality improvements for patients, while reducing costs associated with poor quality outcomes. The guide focuses on the decisions surrounding the comprehensive...