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Patient experience at the time of practice transformation into Patient-Centered Medical Homes

Lisa Kern, Rina Dhopeshwarker, Alison Edwards, Rainu Kaushal


Purpose: The Patient-Centered Medical Home (PCMH) is a model of primary care that is being promoted for its potential ability to improve patient-centeredness, improve quality and decrease costs. The effect of the PCMH on patient experience is not clear, with some reports suggesting that patient experience may worsen during transformation. We sought to measure patient experience at the time practices transform into PCMHs.

Methods: We conducted a cross-sectional survey of 419 adult patients who were cared for by 85 primary care physicians across 12 practices in the Hudson Valley region of New York State. We measured patient experience, using the 35 questions in the Clinician & Group – Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) – Adult Primary Care Questionnnaire (plus 14 additional questions drawn from other survey instruments) and compared the results to national CG-CAHPS benchmarks.

Results: Patients’ experience overall was fairly positive, with 79% giving their doctors a ranking of 9 or 10 on a 10-point scale, with 10 being the highest. Patients’ experience in this sample was significantly more positive than the national benchmark on each of 6 subscales (p ≤ 0.05).  Patients were generally most satisfied with individual face-to-face encounters with their physicians and somewhat less satisfied with processes of care (such as receiving results from a test or receiving follow-up after discharge from the hospital).

Conclusions: This study suggests that medical home transformation does not adversely impact patient experience and identifies organizational processes of care that could potentially be improved with the patient-centered medical home.

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