Replacing poorly coordinated, acute-focused, episodic care with coordinated, proactive, preventive, acute, chronic, long-term and end-of-life care is foundational to the transformation of the U.S. healthcare system. Many believe this can be best accomplished by strengthening primary care and having primary care provider-led (PCP) care delivery teams working at the "top of their licenses" — at the level for which they are qualified and licensed.
One approach to transforming primary care is the patient-centered medical home (PCMH), or the "medical home" — an enhanced primary-care model that provides comprehensive and timely care with appropriate reimbursement, emphasizing the central role of teamwork and engagement by those receiving care.
The PCMH is a model that can be implemented immediately to help address increasing healthcare costs, poor or inconsistent quality and inaccessibility to timely care.
Here is a pretty good video from IBM Social Media: