Are Primary Care Practices Ready to Become Patient-Centered Medical Homes?


  • Funding: This research was funded through a Cooperative Agreement with the federal Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services (Grant # U1C RH20419). The funding agency reviewed this manuscript prior to submission; no substantive changes were made as a result of the review. For further information, contact: Keith J. Mueller, PhD, Department of Health Management and Policy, College of Public Health, University of Iowa, 105 River Street, N232A, CPHB; Iowa City, Iowa 52242; e-mail:


Purpose: To measure the readiness of rural primary care practices to qualify as patient-centered medical homes (PCMHs), one step toward participating in changes underway in health care finance and delivery.

Methods: We used the 2008 Health Tracking Physician Survey to compare PCMH readiness scores among metropolitan and nonmetropolitan primary care practices. The National Committee on Quality Assurance (NCQA) assessment system served as a framework to assess the PCMH capabilities of primary care practices based on their services, processes, and policies.

Findings: We found little difference between urban and rural practices. Approximately 41% of all primary care practices offer minimal or no PCMH services. We also found that large practices score higher on standards primarily related to information technology and care management.

Conclusions: Achieving the benefits of the PCMH model in small rural practices may require additional national promotion, technical assistance, and financial incentives.