Across the nation, dozens of patient centered medical homes are already organizing or operating at the local, regional and state levels. Proof in Practice: A compilation of patient centered medical home pilot and demonstration projects reports the progress of pilots and initiatives, providing descriptions and details of how they are structured and what they are achieving.

Publication of the original PCPCC Pilot Guide in 2008 successfully disseminated the nuts and bolts of the initiatives it featured, some mature and some still developing. Because testing of the efficacy of the PCMH model is still in its infancy, we are pleased that so many pilots include data collection and measurement criteria in their design so that future programs can learn from their efforts. The state-by-state reports included in this edition are drawn from two surveys designed to gather the latest information about the structure and design of programs, but they also bring in new information about evaluation, data collection and consumer engagement efforts.

In addition to the state-by-state results, this Guide includes A Review of the Evidence on Quality, Access and Costs from Recent Prospective Evaluation Studies, a document compiling proof of the model’s promise across a number of initiatives. In addition, the outcomes for four PCMH practices were featured in the September-October 2009 Health Affairs. “American Medical Home Runs” spotlighted pilot sites that have demonstrated a minimum 15 to 20 percent cost reduction in total health care spending for patients per year than patients treated by their regional peers (Milstein, A. and Gilbertson, E., “American Medical Home Runs,” Health Aff (Millwood). 2009;28(5): 1317–26; 10.1377/hlthaff.28.5.1317).

It is important to note that the list of pilots included in this Guide is not exhaustive; for example, we have notattempted to include details on a number of public payer (Medicare and Medicaid) pilots that are also focusing on
demonstrating the value of the PCMH. Much work on that front is being accomplished by our colleagues at the National Academy for State Health Policy, a group that is leading discussions occurring at the state level to adopt standards and define metrics associated with providing a true medical home. They are working closely with the PCPCC’s Center for Public Payer Implementation, making sure that our message resonates just as strongly with public purchasers of care as it does in the private sector.