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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Usual Source of Sick Care.

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Strategy. Medical Home Model Promotion

Approach. Promote medical home model

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Overview. The medical home model emphasizes usable, continuous, comprehensive, family-centered, coordinated and compassionate access to healthcare.[1] Evidence on the pediatric medical home indicates a positive relationship between use of the model and positive health outcomes.[2] Personalized care plans and preventative services are pieces of this model that promote overall health and well-being.[3, 4] Healthcare systems that use the medical home model and its components can better establish a foundation for delivering high-quality, usable, and family-centered care to children.[2]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Qualitative data from focus groups
  • Medical home assessment tools
  • Parent/caregiver perceptions of primary care survey

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.
  • Quality of Care. This strategy promotes the degree to which healthcare services meet established standards aimed at achieving optimal health outcomes.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of primary care practices partnered with Title V adopting patient-centered medical home (PCMH) models. (Measures uptake of medical home model)
  • Number of patients with complex health needs receiving care from PCMH-certified practices. (Assesses engagement in medical homes)

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

  • Percent of PCMH practices meeting national standards for medical home recognition. (Measures fidelity to medical home model)
  • Percent of PCMH care teams engaging patients and families in care planning and decision-making. (Shows patient-centeredness in medical home practices)

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

  • Number of payers and health systems promoting PCMH implementation. (Measures partner engagement in medical home advancement)
  • Number of PCMH learning collaboratives and toolkits developed to support practice transformation. (Assesses knowledge sharing for medical home practices)
  • Number of communities experiencing improved health outcomes through widespread PCMH adoption. (Measures population health impact of medical home spread)
  • Number of primary care training programs incorporating PCMH principles. (Shows influence on workforce development)

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

  • Percent of PCMH initiatives engaging patients from communities. (Measures community partnership in medical home efforts)
  • Percent of PCMH practices demonstrating commitment to addressing structural differences affecting patient health. (Shows impact of initiative on care delivery)
  • Percent reduction in differences in access to comprehensive primary care. (Measures impact of medical home model)
  • Percent of patients from reporting responsive care in their PCMH experiences. (Measures impact of medical home model)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

[1] Medical Home Initiatives for Children with Special Needs Project Advisory Committee; American Academy of Pediatrics. (2002). The medical home. Pediatrics, 110(1 pt 1), 184-186.

[2] Arthur NSM, Blewett LA. Contributions of Key Components of a Medical Home on Child Health Outcomes. Matern Child Health J. 2023 Mar;27(3):476-486. doi: 10.1007/s10995-022-03539-7. Epub 2022 Dec 2. PMID: 36460883.

[3] Bolton RE, Bokhour BG, Hogan TP, Luger TM, Ruben M, Fix GM. Integrating Personalized Care Planning into Primary Care: a Multiple-Case Study of Early Adopting Patient-Centered Medical Homes. J Gen Intern Med. 2020 Feb;35(2):428-436. doi: 10.1007/s11606-019-05418-4. Epub 2019 Oct 24. PMID: 31650401; PMCID: PMC7018887.

[4] Arthur NSM, Blewett LA. Contributions of Key Components of a Medical Home on Child Health Outcomes. Matern Child Health J. 2023 Mar;27(3):476-486. doi: 10.1007/s10995-022-03539-7. Epub 2022 Dec 2. PMID: 36460883.

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.