The concept of the "Medical Home", first proposed by the American Academy of Pediatrics many years ago, has become the buzz word for health care reform with a primary care focus. The theory behind the concept is that by having a doctor that knows everything about your medical history, your personal history, and your family history that it will be possible to improve outcomes and reduce cost. Though this theory was only anecdotal at first, evidence now exists which proves this concept.

Work by Barbara Starfield and others has shown that as the number of primary care providers in a region increases, costs go down and outcomes improve. Conversely, with each additional specialist, there is an increase in cost and a decrease in outcomes. Though the reason for this is still subject to debate, it likely has to do with continuity, and patients not slipping through the cracks. This is not meant to suggest that one type of physician is "better" at doing something than another physician. For example, patients with a medical home, are more likely to have their chronic diseases controlled to better levels, receive preventive care like flu shots, and undergo cancer screenings such as colonoscopies. They are also less likely to have two or three repetitive tests in a narrow time frame as the medical home physician will be aware of what has been done on the patient's behalf, and what does not need to be replicated. Other evidence to support the theory of the medical home and a strong primary care infrastructure is that countries with such a focus have on average better outcomes at a reduced cost.

Further support of the medical home concept was provided when the non-partisan independent Commonwealth Fund released its report in 2007 demonstrating that when a patient has a usual source of care (similar in concept to the medical home) that outcomes are improved and that health disparities for minorities are reduced.

Finally, in 2007 Governor Mike Easley of North Carolina announced that "Community Care of North Carolina" saved the state $231 million. Community Care of North Carolina includes 3,500 primary care doctors who serve as the medical home for Medicaid patients.

As defined by the American Academy of Family Physicians "A patient-centered medical home is simply a better way--a more effective and efficient model of health care delivery" . This new model produces better care and lower costs. In a patient-centered medical home:

• Patients have a relationship with a personal physician.
• A practice-based care team takes collective responsibility for the patient's ongoing care.
• Care team is responsible for providing and arranging all the patient's health care needs.
• Patients can expect care that is coordinated across care settings and disciplines.
• Quality is measured and improved as part of daily work flow.
• Patients experience enhanced access and communication.