HomePilots & Projects Nat'l Demonstration ProjectNDP Background FFM New Model Components

Core Components of the New Model of Care

The new Model of Care proposed by the Future of Family Medicine report and TransforMED has 11 main components:

1. Personal medical home
The practice serves as a personal medical home for each patient, ensuring access to comprehensive, integrated care through an ongoing relationship.

2. Patient-centered care
Patients are encouraged to be active participants in their health and health care. The practice has a patient-centered, relationship-oriented culture that emphasizes the importance of meeting patients' needs, reaffirming that the fundamental basis for health care is "people taking care of people."

3. Team approach
An understanding that health care is not delivered by an individual, but rather by a system, which implies a multidisciplinary team approach for delivering and continuously improving care for an identified population.

4. Elimination of barriers to access
Elimination, to the extent possible, of barriers to access by patients through implementation of open scheduling, expanded office hours, and additional, convenient options for communication between patients and practice staff.

5. Advanced, data-based information systems
The ability to use an information system to deliver and improve care, provide effective practice administration, communicate with patients, network with other practices, and monitor the health of the community. A standardized electronic health record (EHR), adapted to the specific needs of family physicians, constitutes the central nervous system of the practice.

6. Redesigned, more functional offices
Offices should be redesigned to meet changing patient needs and expectations, accommodate innovative work processes, and ensure convenience, comfort, and efficiency for patients and clinicians.

7. Integrated, whole-person orientation
A visible commitment to integrated, whole-person care through such mechanisms as developing cooperative alliances with services or organizations that extend beyond the practice setting, but which are essential for meeting the complete range of needs for a given patient population. The practice has the ability to help guide a patient through the health care system by integrating care-- not simply coordinating care.

8. Care provided within a community context
A culturally sensitive, community-oriented, population-perspective focus.

9. Emphasis on quality and safety
Systems are in place for the ongoing assessment of performance and outcomes and for implementation of appropriate changes to enhance quality and safety.

10. Enhanced practice finance
Improved practice margins are achieved through enhanced operating efficiencies and new revenue streams.

11. Commitment to provide family medicine's consistent set of services
A commitment to provide patients with familymedicine's full basket of services -- either directly or indirectly through established relationships with other clinicians.