Analysis & commentary. Driving quality gains and cost savings through adoption of medical homes.

The U.S. health care system too often falls short in delivering effective primary care, especially for patients with chronic conditions. One potential solution is the patient-centered medical home, a model that has shown success in individual demonstrations. Evidence from seven of the largest medical home pilots shows that four factors are essential: dedicated care managers; expanded access; performance management tools; and effective incentive payments. Federal policy, including implementation of health insurance reform legislation, should consider how to include these core elements and offer guidance and incentives for executing them effectively.