T
his article and the journal supplement it introduces are about the promise of primary care, the growing frustrations of not meeting that promise, and the strategies recently envisioned to try to redis-cover the lost promise. The supplement, which follows up on an earlier report, 1 weaves together different threads about one recent particular part of the story, the implementation and evaluation of the National Demon-stration Project (NDP) of the patient-centered medical home (PCMH).
SEVEN REPORTS THAT TOGETHER TELL A STORY
The NDP tested a new model of care and compared facilitated and self-directed approaches to implementing this model in a group-randomized clinical trial. The NDP asked what a national sample of 36 highly moti-vated family practices could accomplish in moving toward the PCMH ideal during 2 years within the current US health care payment and orga-nizational system. The project was independently evaluated using a multi-Kurt C. Stange, MD, PhD
William L. Miller, MD, MA Paul A. Nutting, MD, MSPH Benjamin F. Crabtree, PhD Elizabeth E. Stewart, PhD Carlos Roberto Jaén, MD, PhD
Confl icts of interest: The authors’ funding partially supports their time devoted to the evaluation, but they have no fi nancial stake in the outcome. The authors’ agreement with the funders gives them complete independence in conducting the evaluation and allows them to publish the fi ndings without prior review by the funders. The authors have full access to and control of study data. The funders had no role in writing or submitting the manuscript.
CORRESPONDING AUTHOR
Kurt C. Stange, MD, PhD
Case Western Reserve University
10900 Euclid Ave, LC 7136
Cleveland, OH 44106 kcs@case.edu ANNALS OF FAMILY MEDICINE
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WWW.ANNFAMMED.ORG
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VOL. 8, SUPPLEMENT 1, 2010
S3
CONTEXT FOR UNDERSTANDING THE NDP AND PCMH method approach that integrated qualitative methods to tell the NDP story from multiple