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October 22/29, 2014

Structuring Payments to Patient-Centered Medical Homes

Author Affiliations
  • 1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
  • 2Divisions of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
JAMA. 2014;312(16):1633-1634. doi:10.1001/jama.2014.9529

There is increasing recognition that the prevailing model of primary care practice that evolved in the United States under the current fee-for-service (FFS) reimbursement system is dysfunctional. Models of enhanced primary care such as the patient-centered medical home (PCMH) are being introduced nationally and are considered a foundational element of new global payment arrangements, such as accountable care organizations. Under these types of arrangements in particular, but in primary care more broadly, primary care practices are expected to reorient toward providing enhanced services designed to both optimize patient experiences and health, which requires a fundamental change in the way primary care practices are reimbursed for their services.