A PCMH emphasizes a team approach to care, typically including physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, and care coor- dinators. This team cooperates to improve access (e.g., after-hours care and same-day visits), patient engagement (e.g., teaching patients how to manage their care and contribute to decision making), care coordination (e.g., tracking care plans among providers and improving transitions from hospitals to home), quality (e.g., improving patient satisfaction and tracking compliance with practice protocols), and safety (e.g., decision support for prescribing and tracking abnormal test results). Despite broad similarities, PCMHs vary in their emphases and implementation strategies. Not surprisingly, reviews find weak, variable evidence that PCMHs save money, although the evidence is stronger and less variable for high-risk patients. Similarly, some studies find improvements in patients’ experiences in PCMH practices, whereas others do not. How much PCMHs improve quality and safety also remains unclear
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