Building a Medical Neighborhood for the Medical Home

Elliott S. Fisher, M.D., M.P.H. in New England Journal of Medicine Volume 359:1202-1205 September 18, 2008 Number 12 Recent efforts to improve primary care in the United States have focused largely on the development and implementation of practice models and payment reforms intended to create a "medical home" for patients. The notion of a medical home makes intuitive sense and indeed has great promise. But unrealistic expectations about this approach abound, and insufficient attention is being paid to several important barriers to the clinical and financial success of the medical-home model.