Patient-Centered Medical Home

The Patient-Centered Medical Home (PCMH) is a healthcare setting that facilitates partnerships between patients, their personal physicians and, when appropriate, the patient’s family to provide a more comprehensive, coordinated and effective healthcare experience.

As defined by the American Academy of Family Physicians (AAFP), the PCMH is “a transition away from a model of symptom and illness based episodic care to a system of comprehensive, coordinated primary care for children, youth and adults. Patient centeredness refers to an ongoing, active partnership with a personal primary care physician who leads a team of professionals dedicated to providing proactive, preventive and chronic care management through all stages of life.”

PCMH Principles:

  • Personal physician access leading a care team
  • Physician directed medical practice
  • Coordinated and/or integrated care
  • Quality and safety
  • Enhanced access
  • Payment to reflect the added value of comprehensive/coordinated care

The Georgia Academy of Family Physicians (GAFP) took the lead in Georgia and established a PCMH University in 2010 to help transform Georgia family physician practices into nationally recognized NCQA medical homes and increase primary care compensation for improving health while reducing healthcare costs.


American Academy of Family Physicians’ PCMH Resources The AAFP’s PCMH resources give you step-by-step project plans and tools to:

  • Start emailing with patients, and get paid for it
  • Put practice finances in order
  • Put a clinical data system in place
  • Offer same-day appointments
Bridges to Excellence (BTE) Introduction to earning BTE Medical Home designation by demonstrating the adoption of effective systematic office processes used to deliver better care and improve patient outcomes, especially regarding chronic conditions.
Delta-Exchange Free access to online networking and education for family medicine practices committed to the PCMH provided by the American Academy of Family Physicians’ TransforMED.
The Joint Commission Updates and information regarding PCMH recognition.
PCMH University A GAFP initiative to help practices receive NCQA PCMH recognition.  To apply for an upcoming PCHM U class, contact GAFP.
NCQA Patient-Centered Medical Home Introduction to the Patient-Centered Medical Home process from the National Committee for Quality Assurance.
NCQA Recognition Training Calendar Online calendar includes NCQA upcoming webinars, teleconferences and other education on becoming a PCMH.
Patient-Centered Primary Care Collaborative Free on-demand continuing medical education activities to be used as a resource through the PCMH recognition process.