Table 1

Basic components of a PCMH (47)

Coordination and integration of careExchange of health-related information through electronic health records; use of patient registries; care coordinator services; the physician arranges care with subspecialists and consultants, guides the patient through the health system
Quality and safetyDecision support based on updated practice guidelines, e.g., incorporation of most current care guidelines in daily patient flow, use of checklists and worksheets to guarantee consistency; use of patient registries to review performance data
Whole person orientationComprehensive care including preventive care and end-of-life care
Personal physicianEach patient has a personal physician who is a first contact for all new health issues; the physician knows the important psychosocial factors that may influence the health of the patient, is culturally competent, and offers long-term comprehensive care.
Physician-directed medical practiceThe physician oversees the health care team whose members communicate closely and is a key link in coordinating their work for the optimal benefit of the individual patient
Enhanced accessFlexible scheduling system; easy access to members of the health care team
PaymentQuality-based payment in addition to fee-for-service reimbursements of face-to-face visits; reimbursement for care coordination; recognition of complexity and severity of illness; sharing of savings achieved from reduced health care costs