NCQA designed its PCMH and PSCP recognition processes to help practices define the standards for patient-centered structure and articulate the necessary change processes. Many practices and organizations choose to evolve to capitalize on opportunities for compensation, as several private payers and state Medicaid programs recognize and reward medical homes through care coordination fees, increased payment for evaluation and management services, or quality and outcome bonuses. Process changes must take place for workflow and increased efficiency, but culture change also is pivotal, including:

• A transition from physician-oriented focus to a patient-centric focus
• Activating patients’ engagement with their health and wellness
• Establishing the primary care provider as a first point of contact for care

Adoption of this model requires visionary leadership, communication with and education of the staff, management of the practice’s entire patient population and, most importantly, the ability to manage change as a team.