Pay for Innovation or Pay for Standardization: How to Best Support the Patient-Centered Medical Home

The report recommends improved ways in which primary care practices should be paid for delivering services to patients in order to improve health care quality and control costs, ranging from new fees for services such as nurse care managers to help patients manage chronic diseases, to comprehensive payments that would completely replace the fee-for-service system. It also cautions against moving too quickly to require primary care practices to meet detailed accreditation standards in order to receive improved payments, and particularly cautions against establishing requirements that serve as barriers to participation by small physician practices without strong evidence that the requirements improve quality.