Building the case for the patient-centered medical home.

Five years have passed since the Future of Family Medicine report warned that the position of family medicine in the United States would be “untenable in 10 to 20 years unless changes occur in the broader health system and within the specialty.” To the casual observer, it may appear that not much has changed in five years, but family medicine leaders see a better future on the horizon. The focus of much of their optimism is the patient-centered medical home, a concept with origins in the “new model” of care called for in the Future of Family Medicine report. The concept – and the blended payment model that underlies it – has captured the imagination of payers, employers and policymakers, as well as many in organized medicine, and its influence is growing. Whether patient-centered medical homes will revitalize the U.S. health care system remains to be seen, but many family medicine leaders say the widespread interest surrounding the concept has helped put primary care at the center of most health care reform discussions. As the patient-centered medical home takes shape, family physicians are watching and waiting to see what develops and what difference it might make for their practices.