Do nurse practitioner-led medical homes differ from physician-led medical homes?


      • NP‐led PCMHs were more likely to be located in rural and primary care health professional shortage areas, serving vulnerable and medically underserved population than physician-led PCMHs.
      • NP-led PCMHs tended to be more responsive to population health needs in the areas during the recognition process, while physician-led PCMHs emphasized practice improvements through enhanced access to care and management of patient information data.
      • The cluster analysis confirmed that practices demonstrated strengths in different PCMH domains. Meeting recognition standards involves flexibility in implementation, allowing for varying degrees of emphasis on processes designed to enhance primary care.



      The patient-centered medical home (PCMH) is an enhanced model of primary care. This study examined to what extent nurse practitioner (NP)-led PCMHs differed from traditional physician-led PCMHs.


      We tested for differences between 391 NP-led PCMHs and 11,479 physician-led PCMHs, as well as across two distinct clusters identified by the Two-Step cluster analysis procedure using a sample of 136 practices.


      NP‐led PCMHs were more likely to serve vulnerable populations in rural and underserved areas than physician-led PCMHs. NP-led PCMHs tended to be more responsive to population health needs in the areas during the recognition process, while physician-led PCMHs emphasized practice improvements through enhanced access to care and management of patient information data.


      The findings suggest possible differences in capabilities, priorities and needs of the population served across practices. This is an important guide as policymakers track the adoption of PCMHs.


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