Patient-centered Medical Home (PCMH) Recognition: A Time for Promoting Innovation, Not Measuring Standards

William L. Miller, MD, MA


J Am Board Fam Med. 2014;27(3):309-311. 

In This Article

Abstract and Introduction


Disruption, uncertainty, fear, promise, change, frustration, and energy all bundle together uncomfortably in our current unstable and unpredictable climate of health care reform and turbulence. The troubled landscape of family medicine and primary care offers stark evidence of this, and the patient-centered medical home (PCMH) represents an exciting possibility out of this predicament. In such times, it is all the more essential that primary care practices, payers, policymakers, and users get much needed guidance, assurance, and transparency about what changes and emerging innovations are most likely to be beneficial. The National Committee for Quality Assurance's (NCQA) PCMH recognition program intends to do just that. The policy brief in this issue[1] strongly suggests otherwise. Only 40% of a national cohort of primary care practice innovators sought and achieved NCQA PCMH recognition, and 45% of this national cohort did not even consider seeking such recognition for their work and innovations. Unfortunately, these findings are not surprising and support what others have suggested.[2] Why? One possibility is that the NCQA criteria do not recognize many of these innovations. Another is that the innovators find the burden of obtaining recognition greater than any benefit. But it does not have to be this way.