Denise D. Quigley, PhD

Medicare Advantage customer service supports a less healthy, higher-need population, indicating that it should be designed and staffed to effectively serve complex, high-need patients.

Health plans use data to decide on quality improvement initiatives. Having a dashboard that characterizes how equitably plans are serving their enrollees would promote health equity.

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Patient-Centered Medical Home survey assists practices by targeting improvement, standardizing care delivery, discussing best practices, improving provider-patient communication, coordinating care, and supporting patient self-management.

Practices undertake many care delivery changes and quality improvement practices to become patient-centered medical homes (PCMHs), and these differ by years of PCMH recognition.

Patient ratings of plans and care were lower among beneficiaries filing complaints or reporting denied care. Appeals did not further predict ratings, but successful complaint resolution did.

We reviewed operational details and content of tools designed to evaluate patient-centered medical home (PCMH) transformation. These tools assist practice leaders in understanding specific information about the process and progress of becoming a PCMH.