In a recent Health Affairs Blog post, David Keller traces the history of the medical home concept and issues a call to recapture the focus on the patient. Keller's take on patient-centeredness is less combative than David Berwick's perspective in the 2009 Health Affairs article "Confessions of an Extremist."

    The patient-centered medical home (PCMH) concept is at the center of health care system transformation-a central objective of the Affordable Care Act.  The PCMH model is perceived as having the potential to improve quality, reduce cost, and ameliorate fragmentation.  However, there are few studies that evaluate PCMH using comparable measures.

      The Commonwealth Fund launched the  Patient-Centered Medical Home Evaluators’ Collaborative to address this problem.  However, the indicators selected by the expert panel did not include patient satisfaction measures.   Dr. Keller's position is echoed in the  Editor's Perspective section of the American Heart Association's publication Circulation, adding a call for rigorous evaluation of the patient-provider relationship in the context of the medical home.

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