Pediatric practices not ready for certification as medical homes

Most primary care practices for children are not yet ready for certification as medical homes, according to a new study that assessed practice characteristics associated with successful medical home programs.   Researchers used data from years 2007 and 2008 of the National Ambulatory Medical Care Survey to identify approximately 600 pediatric practices, family practices, and general practices serving children aged younger than 19 years and mapped their physician and practice characteristics with 2011 National Committee on Quality Assurance (NCQA) certification standards for patient-centered medical homes. Each practice was assigned a medical home infrastructure score based on a 100-point scale.   On average, pediatric practices met 38% of medical home infrastructure points required for certification and family and general practices attained 36%. A score of 35% is the minimum threshold for medical home certification in the NCQA program.   Multivariate analyses found that smaller practice size-a solo practitioner or the 2-physician model-was associated with a lower infrastructure score when compared with medium and large pediatric practices. Fewer smaller practices reported using computerized systems to facilitate patient care, a core component of the score.    The overall low scores reflect growing concern that many pediatric, family, and general practices lack the ability and financial resources to qualify for certification as medical homes, which effectively limits care for children, especially those with special health care needs.    Zickafoose JS, Clark SJ, Sakshaug JW, Chen LM, Hollingsworth JM. Readiness of primary care practices for medical home certification.

Pediatrics.

2013;131(3):473-482.