The Journey Towards the Patient-Centered Medical Home

The REACH Foundation’s interest in patient-centered medical care and the medical home movement stemmed directly from the foundation’s mission: To inform and educate the public and facilitate access to quality healthcare for poor and underserved people. After making significant program and core operating grant investments in the Kansas City region’s primary care safety net clinics in the foundation’s first three years of grantmaking, 2005-2008, REACH staff noted the considerable variation among its grantee clinics in terms of organizational capacity, staffing, availability of services, utilization of health information technology, and commitment to quality improvement and patient-centered care. Recognizing that nonprofit clinics seldom have the financial resources to engage high-quality practice transformation consultants, and with a desire to advance consistency across the safety net health care delivery system, REACH invited its grantee clinics to participate in the PCMH initiative. Rather than provide individual grants to individual clinics to engage a consultant, REACH staff contracted with an expert technical assistance provider to work with the participating clinics individually and in group settings. 
 
During the planning stages of the Medical Home Initiative, the REACH Foundation executives identified a number of key drivers, resources, and emerging models that motivated them to explore options supporting a more optimal, coordinated health care framework. The leaders at the REACH Foundation became aware of the PCMH movement while following the work of The Commonwealth Fund’s Safety Net Medical Home Initiative (see below), which launched its planning year in 2008, followed by four years of technical assistance to 65 primary care safety net sites in five states. PCMH initiatives were novel then, but the concept gained momentum through the applied work of early adopters in that timeframe. The key drivers of the REACH Medical Home Initiative are also excellent resources for others interested in learning more about the topic.