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Patient-Centered Medical Home and Quality Measurement in Small Practices
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Patient-Centered Medical Home and Quality Measurement in Small Practices

Jason J. Wang, PhD; Chloe H. Winther, BA; Jisung Cha, PhD; Colleen M. McCullough, MPA; Amanda S. Parsons, MD, MBA; Jesse Singer, DO, MPH; and Sarah C. Shih, MPH
Small practices with NCQA patient-centered medical home recognition perform better on quality measures, especially those related to chronic conditions.
Whether practices that became PCMH-recognized already had higher performance on quality measures or were able to improve their performance on quality measures through PCMH transformation, our findings suggest that these practices have higher rates of quality measurement in 7 areas of preventive care. As is currently under CMS consideration, PCMH recognition may serve as a marker to consumers in helping them select high-quality practices, and to payers who are looking to differentiate among their network clinicians.30 However, better care and health could be achieved if all practices continued to improve over time. Efforts to further encourage all practices to demonstrate improvement on preventive care for patients with chronic conditions could be supported by PCMH transformation. Further rewards for practices and areas of care that may have been reaching a ceiling, such as smoking status recorded or BMI recorded, would be wasted resources that could be used to assist lower performers on areas of care with direct impact on improved population health. Finally, further monitoring over time will determine if PCMH recognition continues to produce positive health outcomes for patients with chronic conditions.

Author Affiliations: New York City Department of Health and Mental Hygiene, Primary Care Information Project, Queens, NY (JJW, CHW, JC, CMM, ASP, JS, SCS).

Source of Funding: New York City Tax Levy and the Agency for Healthcare Research and Quality R18 HS019164.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (JJW, CHW, JS, SCS); acquisition of data (JJW, JC, CMM, SCS); analysis and interpretation of data (JJW, JC, CMM); drafting of the manuscript (JJW, CHW, CMM, ASP, SCS); critical revision of the manuscript for important intellectual content (JJW, CHW, CMM, ASP, SCS); statistical analysis (JJW, JC); provision of study materials or patients (AP, JS); obtaining funding (ASP); administrative, technical, or logistic support (JJW, CHW, JS, SCS); supervision (JJW, JS, SCS).

Address correspondence to: Jason J. Wang, PhD, New York City Department of Health and Mental Hygiene, Primary Care Information Project, 42-09 28th St, 12th Fl, Queens, NY 11101. E-mail: jwang5@health. nyc.gov.
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