Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes. Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety of the type of health care being provided to the patient in question, in accordance to the patient's medical history and ailments. This model of health care caters to all sorts in the population from children to senior citizens. The PCMH team model encourages the team of physicians and medical experts to show compassion, be accessible, and build a relationship with the patient based on transparency, healthy communication and of course trust. Each PCMH uses up-to-date, advanced modern technology in the health care that aids in the success of the venture. Payments for the medical care have been made easier with new innovative methods that do not put much burden on the patient of health care bills. PCMH is widely accepted because of the way it not only treats people from their diseases but also cares for their future, family and finances.

PCMH have certain features that set them from apart from other regular hospitals. These are the standard features of all PCMH, and are mentioned in the Accreditation Association for Ambulatory Health Care's Handbook for the purpose of being accredited as a certified PCMH. Being a medical home, its aim is to deliver all sorts of primary care, with all sorts of physicians and medical practitioners located in the same premises so that the patient can find whichever physician he wants treatment from. Another aspect of PCMH is that they are patient-focused. The physicians in a PCMH ensure that the decisions and wishes of the patients and their families are respected with regarding to the treatment procedures and approach taken. They enable the patients to not only participate in their own care but also educate them in the ailments and cures available in order to them to make well-informed, well-thought out decisions. These PCMH are comprehensive when it comes to the performance of their job, which is to tend to the patient's health and other medical needs, and wholly and solely take it in their responsibility. The health needs not only involve the physical needs, but also the mental wellness of the patient as well as prevention of any disease and emergency chronic care. The method of providing the health care is well coordinated. With systems in place at hospitals, specialty care units, home health care etc. The major feature is that it is accessible to patients at all times for any emergency situations that might arise. The PCMH make medical health care service available via "24/7" service centers, after-hours care units, and telephonic access to medical advice. Equipped with the best medical technology that the era has to offer, the quality of the care being provided to the patient is the best that can be done for the diseases at the time. The availability of such equipment allows it easier for the patient and their families to make informed decisions regarding the medical care that the patient requires.

The idea, the vision and the concept of PCMH has been present for quite some time now, but the implementation of this policy has been rather recent in the United States of America. The idea was considered to be equivalent to achieving a milestone in the medical and the social healthcare field in the United States. PCMH has been supported by many different business and companies that aim towards reforming the health care sector in the U.S. Many different projects have been launched by several public and private-based organizations since 2002. One of the most famous projects has been the 'Patient-Centered Primary Care Collaborative' that was launched in 2006 (Backer, 2009). The project has been started by several organizations, including...

Based on the immense support and the possible advantages, it was estimated in 2004 that the costs of health care would be reduced effectively by almost 5.6% annually if PCMH projects were started, which would result in the saving of over 67 billion dollars each year, and the quality of health care would also increase, thus resulting in an efficient, cost effective and highly socially beneficial health care in the U.S. (Spann & Team, 2004).
Although the time period since the PCMH projects have launched and become part of the U.S. health care system has been relatively short, the findings from them have been encouraging in health care terms and also economical and social terms in the country. It has been noted that patients that have been provided with health care in medical homes have been more prepared in managing their chronic diseases rather than those who do not go to medical homes. These patients become more aware of their diseases as medical homes also aids them in understanding their diseases and providing knowledge about them so that the patient becomes less reliant on curing medical care and focuses on preventive care. For example, the U.S. citizens who visit such medical homes and clinics have been noticed to be more likely to report about checking their blood pressure levels and in keeping the levels in control. Moreover, the medical homes have resulted in disparities amongst the general population of the country based on the ethnic grounds have reduced in the availability, accessibility and receipt of health care services. Primary beneficiaries of this advantage have been to the Afro - Americans and Hispanics in the country. Prior to the introduction of medical homes, these people could not access the expensive health care services as they were only accessible to white people in the country. Moreover, they did not acquire enough income so as to receive services from the private doctors and medical clinics. The medical homes also have benefitted the lower income group and the uninsured people in the country. PCMH has provided them a chance to be able to acquire high quality health care services in the country on low cost.

The advanced nurse practitioners (ANP) are those personnel who get involved with patient on a more focused basis as a personal provider who looks after the whole person rather than focusing on only one disease or medical problem. The ANP's have been responsible in the medical homes to provide safe and high quality care to the patients as part of the overall health care providence. Commonly, ANPs have been noted to provide mostly primary health care. But in medical homes, the role of the ANP increase drastically as they are also responsible to provide the patient assistance not only on the health care level but also on the mental level to encourage the patients to be more preventive and precautionary about their health. These ANPs have the role to provide higher level of care to the patients so that they are encouraged to come to medical homes rather than opting for expensive private doctors who only focus on the primary disease, ignoring other issues most of the time. The health care reforms in the U.S. have revealed at least two unique roles of the practice of ANP's in medical homes. These are providing high quality health care to patients and establishing unique involvement of ANP's i.e. they can focus on contributing to the health care in medical homes to patients by focusing primarily in the diseases of chronic nature (De Geest, Moons, Callens, Gut, Lindpaintner, & Spirig, 2008).

The idea of medical homes has been established on the requirement of providing all the people equal and high health care facilities. Another reason was the inefficiency and disparities based on income level and ethnicity in the country. These factors laid down the basis for the development of such Patient Centered Medical Homes in USA. The issues can be more elaborated to explain their definitions. The issue of high cost by medical practitioners, especially the expensive private health care services raised the concerns about the lack of accessibility for high cost health care for the lower income group of the nation. The policy or legislation would help the poor people of the country to be provided with advanced high quality health care by PCMH.

Health care is an expensive ordeal mostly for the lower income groups in the United States. The under privileged and the poor people are usually unable to seek health care from…