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The Medical Home Neighborhood

The American Academy of Pediatrics introduced the medical home concept in 1967, and in 2007 leading primary care-oriented medical professional societies released the Joint Principles of the PCMH. The next year, NCQA released its PCMH Recognition program for primary care practices, the first evaluation program in the country based on the PCMH model. 

The medical home model of care delivers whole-person care that is coordinated and tracked by one primary care provider. Providers outside of the medical home that connect with that primary care provider are vital partners to make the medical home neighborhood effective for patients. 

NCQA also has programs that recognize other types of practices that make up the medical home neighborhood. Since 2007, NCQA added the Patient-Centered Specialty Practice (PCSP) Recognition Program for specialty practices and the Patient-Centered Connected CareTM Recognition Program for other ambulatory care sites like onsite employee health clinics, retail clinics and urgent care centers. 

These programs help facilitate team-based care by improving collaboration with primary care and recognizing practices that streamline and improve health care delivery. 

As of March 2017 more than 12,000 primary care practices (with more than 60,000 clinicians) have been recognized as medical homes by NCQA and 43 states have embraced the PCMH model.1 Another 200 specialty practices, representing more than 1,200 clinicians, have achieved PCSP Recognition. And almost 50 sites are recognized under NCQA’s Patient-Centered Connected Care Recognition Program. The medical home neighborhood model: 

  • Supports “team-based care” that frees providers to work to their highest level of training. 
  • Aligns use of information technology to help providers support the Triple Aim and improve population health. 
  • Demonstrates a commitment to quality and quality improvement. 
  • Has been proven to reduce health care costs, especially for people with complex chronic conditions. 2,3,4
  • Improves patient satisfaction.5

1 Nielsen, M., Gibson, L., Buelt, L., Grundy, P., & Grumbach, K. (2015). The patient-centered medical home’s impact on cost and quality, review of evidence, 2013-2014 

2 Higgins, S., Chawla, R., Colombo, C., Snyder, S., & Nigam, S. (2014). Medical homes and cost and utilization among high-risk patients. American Journal of Managed Care. 20(3), 61-71 

Van Hasselt, M., McCall, N., Keyes, V., Wensky, S.G., & Smith, K.W. (2014). Total cost of care lower among Medicare fee-for service beneficiaries receiving care from patient-centered medical homes. Health Services Research 

4 Department of Vermont Health Access. (2013) Vermont blueprint for health. Retrieved April 7, 2015 from 

5 Hartford Foundation (2014) Older adults report positive experiences with team-based approach to care. Retrieved April 7, 2015 from