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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 1: Well-Woman Visit

MCHbest Logo well-woman visit

Strategy. Medical Homes

Approach. Support the development of a medical home care model to be implemented within clinics statewide.

Source. Robert Wood Johnson Foundation's What Works for Health (WWFH) Database

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Overview. Patient-Centered Medical Homes (PCMHs) provide continuous, comprehensive, primary care (NCQA-PCMH, AHRQ-PCMH). In this model of care, primary care providers and their teams coordinate care across the health care system, working with patients to address all their preventive, acute, and chronic health care needs. Arranging care with other qualified health professionals as needed, medical homes offer enhanced access, expanded hours, and easy communication options for patients.

Evidence. Scientifically Supported. There is strong evidence that medical homes improve quality of health care and access to care (van den Berk-Clark 2017*, Olayiwola 2017, Alexander 2012*, van Walraven 2010*, Rosenthal 2008, Homer 2008, Hoff 2013*), and increase the use of preventive services compared to traditional care (Sinaiko 2017, Olayiwola 2017, Hadland 2014, Jackson 2013, Alexander 2012*). Read more in theĀ WWFH database report. Read more about WWFH's evidence ratings. (*Links to citations can be accessed through the WWFH database).

Target Audience. Systems/Patients.

Outcome. Percent of women, ages 18 through 44, with a preventive medical visit in the past year.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Support the development of a medical home care model to be implemented within clinics statewide,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of clinics offering medical home services.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of clinics offering medical home services.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of women who report having a medical home for preventive care service needs.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of women who report having a medical home for preventive care service needs.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.