Defining the medical home: the Oregon experience

Objective: the patient-centered medical home (pcmh) is emerging as a key strategy to improve health outcomes,reduce total costs,and strengthen primary care,but a myriad of operational measures of the pcmh have emerged. in 2009,the state of oregon convened a public,legislatively mandated committee charged with developing pcmh measures. we report on the process of,outcomes of,and lessons learned by this committee. methods: the oregon pcmh advisory committee was appointed by the director of the oregon department of human services and held 7 public meetings between october 2009 and february 2010. the committee engaged a diverse group of oregon stakeholders,including a variety of practicing primary care physicians. results: the committee developed a pcmh measurement framework,including 6 core attributes,15 standards,and 27 individual measures. key successes of the committee's work were to describe pcmh core attributes and functions in patient-centered language and to achieve consensus among a diverse group of stakeholders. conclusions: oregon's pcmh advisory committee engaged local stakeholders in a process that resulted in a shared pcmh measurement framework and addressed stakeholders' concerns. the state of oregon now has implemented a pcmh program using the framework developed by the pcmh advisory committee. the oregon experience demonstrates that a brief public process can be successful in producing meaningful consensus on pcmh roles and functions and advancing pcmh policy.