Background Few studies have evaluated whether the patient-centered medical home (PCMH)

Background Few studies have evaluated whether the patient-centered medical home (PCMH) supports patient activation and none have evaluated AdipoRon whether support for patient activation differs among racial and ethnic AdipoRon groups or by health status. surveys produced a 0-100 score for PCMH characteristics. Patient surveys used the patient activation subscale of the Patient Assessment of Chronic Illness Care to produce a 0-100 score for patient perception of clinic support for patient activation. Results Across all patients we did not find a statistically significant association between PCMH score and clinic support for patient activation. However among the subgroup of minority patients in fair or poor health a 10-point higher PCMH score was associated with a 14.5-point (CI 4.4-24.5) higher activation score. Conclusions In a population of safety net patients higher-rated PCMH characteristics were not associated with patients�� perception of clinic support for activation among the full study population; however we found a strong association between PCMH characteristics and clinic support of activation among minority patients in poor/fair health status. The PCMH may be promising for reducing disparities in patient activation for ill minority patients. Keywords: PCMH medical home disparities patient activation INTRODUCTION The patient-centered medical home (PCMH) is a model of care that advocates believe is central to achieving the ��triple aim�� of improving health controlling costs and enhancing patient experience in primary care.1 Core components AdipoRon of the PCMH include comprehensive primary care enhanced access care management and quality improvement; all directed toward the fundamental goal of orienting care around the needs of the patient.2 3 There is significant momentum behind the adoption of the medical home with coalitions of industry stakeholders and health care policymakers calling for widespread use of the model in primary care.1 One RUNX2 anticipated benefit of the model is that the PCMH will better-position health care systems and providers to support a patient��s active role in maintaining their health and managing their diseases.4 A growing body of literature has demonstrated the benefits of patients taking an active role in their health care. Formally defined patient activation refers to the possession of ��knowledge skills and confidence people need to manage their health and health care.��5 The concept is an important aspect of patient-centeredness one of the six fundamental aims of a high performing health system.6 Patient activation can lead to a broad range of health benefits such as higher rates of recommended screening reductions in unhealthy behaviors improvements in blood pressure and cholesterol and fewer emergency department visits and hospitalizations.7 Nationally levels of patient activation are known to differ between racial and ethnic groups with lower levels of activation reported among black and Hispanic patients compared to whites.5 8 9 Activation also tends to be lower among individuals with poorer self-rated health status.9 10 While the determinants of patient activation are complex specific activities of primary care providers such as soliciting patient ideas about treatment have been shown to be associated with improved patient activation.11 12 13 There has been little quantitative study of whether medical homes support activation. Four previous studies have examined patient activation or related concepts such as patient engagement empowerment and goal-setting as part of larger analyses of patient satisfaction and experience with care. 14 15 16 17 Evidence from these studies was mixed with two studies finding that the PCMH was associated with AdipoRon patients experiencing greater support for patient activation and related concepts14 15 and two finding no association.16 17 Existing studies have been limited AdipoRon by the use of PCMH measures that did not address important components of the PCMH 15 17 reliance on the responses of a single individual within a clinic to generate that clinic��s PCMH rating 15 16 17 response rates of less than 30 percent 15 16 17 or study of a single PCMH implementation site.14 Importantly no published studies have focused on whether the PCMH supports patient activation in the safety net population nor have any studies examined whether support for patient activation in a PCMH differs among racial/ethnic or health status groups. Our.