Table 3.

Summary of Key Stakeholder Perspectives on Medical Home Principles

	Primary Care Providers	Clinic and Health System Administrators	Insurers and Payers	Policymakers
Personal physician	Familiar concept Highly valued	Familiar concept Not highly valued	Familiar concept Not highly valued	Familiar concept Somewhat valued
Physician-directed medical practice	Foreign concept May be reluctant to participate in team- based care	Good understanding of team dynamics and differing roles of primary care team members	Very limited understanding of team-based primary care	Very limited understanding of primary care teams and roles
Whole-person orientation	Familiar concept Important core value of primary care	Limited understanding of concept Not highly valued	Limited understanding of concept Not highly valued	Some understanding of concept Somewhat valued
Care is coordinated and/or integrated	Limited understanding of care coordination strategies (patient-level focus) Sometimes part of current practice Variable understanding	Limited understanding of care coordination strategies (systems-level focus) Some understanding	Some understanding of concept May not link care coordination to the medical home (caved out services) Highly valued	Some understanding of concept Limited understanding of quality improvement Not valued
Quality and safety	Variable desire to participate in new projects Skeptical of new requirements/oversight	Importance driven by regulatory and licensure requirements	Favor tighter regulation and oversight of primary care to improve quality and safety	Highly valued (regulatory mindset)
Enhanced access	Well understood Limited support because of overwork of providers in current system	Well understood Customer-service mentality	Well understood (emphasis on customer service and costs) May not link to medical home	Well understood Somewhat valued
Payment	Very highly valued, of critical importance Skeptical of pay-for-performance	Very highly valued, of critical importance Skeptical of new payment methodologies	Very sensitive to rising health care costs Likely to demand proof of value/cost savings	Extremely sensitive to overall system costs and impact on health care budgets Supportive of demonstrations