Perceptions of High-Risk Patients and Their Providers on the Patient-Centered Medical Home

Shreya Kangovi, Katherine Kellom, Christopher Sha, Sarah Johnson Conway, Casey Chanton, Tamala Carter, Judith A. Long, David Grande

Research output: Contribution to journalArticle


To explore perceptions of high-risk patients and their practice staff on the patient-centered medical home, we conducted a multisite qualitative study with chronically ill, low-income patients and their primary care practice staff (N = 51). There were 3 key findings. Both patients and staff described a trade-off: timely care from an unfamiliar provider versus delayed access to their personal physician. Staff were enthusiastic about enhancing access through strategies such as online communication, yet high-risk patients viewed these as access barriers. Practices lacked capacity to manage high-risk patients and therefore frequently referred them to the emergency room.

Original languageEnglish (US)
Pages (from-to)134-143
Number of pages10
JournalJournal of Ambulatory Care Management
Issue number2
Publication statusPublished - Dec 1 2015



  • Chronic illness
  • health disparities
  • patient engagement
  • patient-centered medical home
  • population management
  • primary care redesign

ASJC Scopus subject areas

  • Health Policy

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