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Most Healthcare Organizations have changed their conceptual approach to their structure and methods in order to be in placement with the Process Centered Concept. This is due to an extensive concern on high and increasing expenses joined with rising proof that the value of health care differs a lot. This has put health care improvement next to the top of the domestic strategy program. Strategy inventors encounter growing pressures to restructure provider payment systems to encourage changes in how providers are organized and offer care.

An example of such organizations is the Centre for studying Health System Change located in Washington D.C. The organization in collaboration with the Mathematica Policy Research specially addresses operational matters concerning medical homes (Barbara 1998). They have done it through identifying significant operational issues in the accomplishment of most medical home models that have possibilities to create or break a successful plan. First of all, they have recognized methods of qualifying physicians Practices as Medical Homes through constructing Medical Homes on a solid primary care foundation. Their public and private payers are introducing patient-centered medical home trials as one approach to advance the value and coordination of care, potentially lower expenses as well as increasing financial assistance to primary care doctors. The experiments look for testing medical home ideas that highlight the central meaning of primary care to a planned and patient-centered health care method.

They have also done this by suggesting the idea of matching patients to medical homes through ensuring patient and physician choice. They have let the physicians know which patients they are supposed to handle so that the performances can coordinate the care of the patients. The organization has also recommended payment and delivery system restructuring under discussion where the medical homes can gain important momentum in both the public and private segments. This idea has been supported by primary care physician societies. It has also been promoted by a wide variety of insurers and payers like the Blue Cross Blue Shield Association, Aetna, United Health Care and Medicaid Programs which are increasing medical home programs. Similarly, Congress has permitted a medical home expression in fee for service Medicare (World Health Organization 1978).

The organization has also addressed the issue of information exchange challenge and suggested that the possibility of medical homes to advance quality and decrease expenses by developing coordination of the care across donors, care location and clinical situations will be limited without successful methods for exchanging clinical information with patients and contributors outside of the medical home. Therefore an open agreement between the medical home and the patient pointing the functions and duties of both could help with the exchange of information. Exchanging information with experts may not be possible without some kind of electronic exchange or inducement for specialists to get involved.

Lastly, the HSC and the MPR have also addressed the issue of paying for medical homes which is a calculated risk.  Payment strategies for medical homes under existing fee for service payment methods basically focus on additional payment for presently exposed services.  They suggested that recovery in interest among policy creators in the medical home ideas develops from aims of advancing quality and decreasing health care expenses. The search for vehicles to enlarge financial assistance for primary care doctors is another driver of backing for the model. This is because their services are largely recognized to be undercompensated in existing fee for service payment schemes. It is especially based on the act that current fee for service payment structures naturally do not pay for significant activities that primary care doctors act upon like care coordination and training patients (Institute of Medicine1996).

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