Evaluating the implementation of the primary care home in Oregon: Community-level health reform

Community health planning in Oregon is designed to achieve the “Triple Aim” of better health, better care and lower costs. As part of statewide health system reform efforts, Oregon implemented the Patient-Centered Primary Care Home (PCPCH) Program, an initiative established in 2009 by the Oregon Legislature. The Oregon Health Authority (OHA), which houses the PCPCH Program, administers the application, recognition, and verification process. All PCPCH's are required to demonstrate capacity in six core attributes in order to be recognized and receive enhanced funding: access to care, accountability, comprehensive whole person care, continuity, coordination and integration, and person and family-centered care. An evaluation was designed to assess implementation by the first 205 recognized PCPCH's. One hundred and eighty-one practices responded to a web-based survey (88% response rate). The results show progress towards Oregon's goal of improving the experience of care and the efficiency of service delivery, with improved ability to reach communities demonstrated in each of the six core attributes. Evidence from this evaluation is informing OHA as it revises the PCPCH recognition standards, and expands the recognition program. This work is contributing to Oregon's health systems reform efforts, as well as to the policy process and primary care practice in communities. Early implementation of the PCPCH model of care shows progress towards Oregon's goal of achieving the “Triple Aim” of better population health, better individual care and lower costs. Thorough review of Oregon's work in improving health services in communities can have implications for policy delivery throughout the country.