Development and Validation of the Modified Patient-Centered Medical Home Assessment for the Comprehensive Primary Care Initiative

Development and Validation of the Modified Patient-Centered Medical Home Assessment for the Comprehensive Primary Care Initiative

Published: Apr 01, 2018
Publisher: Health Services Research, vol. 53, no. 2
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Associated Project

Evaluation of the Comprehensive Primary Care Initiative

Time frame: 2012-2023

Prepared for:

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services

U.S. Department of Health and Human Services, Center for Medicare & Medicaid Innovation

Authors

Dmitriy Poznyak

Deborah N. Peikes

Breanna A. Wakar

Randall S. Brown

Robert J. Reid

Objective

To describe the modified Patient-Centered Medical Home Assessment (M-PCMH-A) survey module developed to track primary care practices’ care delivery approaches over time, assess whether its underlying factor structure is reliable, and produce factor scores that provide a more reliable summary measure of the practice's care delivery than would a simple average of question responses.

Principal Findings

Confirmatory factor analysis suggested using seven factors (splitting one domain into two), reassigning two questions to different domain factors, and removing one question, resulting in high reliability, construct validity, and stability in all but one factor. The seven factors together formed a single higher-order factor summary measure. Factor scores guard against potential biases from equal weighting.

Conclusions

The M-PCMH-A can validly and reliably track primary care delivery across practices and over time using factors representing seven key components of care as well as an overall score. Researchers should calculate factor loadings for their specific data if possible, but average scores may be suitable if they cannot use factor analysis due to resource or sample constraints.

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