Although research has already found that the medical home model improves children's' health, transitioning to this format has proven daunting for the settings in which most American kids get care: small medical practices.
The majority of primary care for children still occurs in small practices with five or fewer physicians, according to an announcement from the University of Michigan Health System, which conducted its research at C.S. Mott Children's Hospital.
"These practices may be less likely to have the additional resources needed to become recognized as medical homes and miss out on the additional resources and financial support that often comes with participation in medical home programs," noted researchers, whose work is published online in Pediatrics.
"Getting recognized as a medical home is often the first step for practices to participate in programs that are trying to improve primary care for children. These practices can be at a serious disadvantage," lead author U-M pediatrician Joe Zickafoose said in the announcement.
Developing the needed infrastructure, particularly with regard to health information technology, quality measuring and reporting, was seen as the biggest barrier keeping small offices from becoming medical homes. According to the study, pediatric and family medicine practices on average met only38 percent of the National Committee for Quality Assurance's medical home criteria that could be measured by the survey. However, practices scored higher on medical home elements related to direct patient care, such as providing comprehensive health assessments, according to investigators.