PCMH TC: Team-Based Care and Practice Organization

TC09 – Role of the Medical Home

Medical Home Information

Implementation Date: 05/28/2021

Apple Pediatrics has a process and materials that it provides patients, families, and caregivers on the role of the medical home.


It is the policy of the practice to provide all patients with comprehensive information about the role of the medical home, to include the following:

  • Apple Pediatrics role in coordinating patient care across multiple settings;

  • Instructions on obtaining care and clinical advice during office hours and when the office is closed;

  • The importance of providing a complete medical history and information about care obtained outside of the practice.

  • Access to evidence-based care, education, and self-management support;

  • The scope of services available within the practice, including how behavioral health needs are addressed; and

  • Apple Pediatrics commitment to equal access for all their patients regardless of source of payment.


Apple Pediatrics provides patients, families, and caregivers information on the obligations of the medical home, as well as the responsibilities of the parents and caregivers as partners in care. Specific services that patients can expect from the practice, whom to contact for specific concerns, questions and information, and the roles of the care team are explained in writing in a handout that is given to families at their first visit to the practice and is available at the front desk for established patients. This information is also available on the practice website.

The information provided includes, but is not limited to:

  • Goals: A concise statement of the principles of the patient-centered medical home, and the practice’s intended role to care for and coordinate the range of the patient’s care across all settings.

  • Access: Office hours, telephone numbers, where to seek after-hours care, and how to communicate with and request clinical advice after office hours. The practice provides equal access for all patients, regardless of insurance status. Equal access regardless of insurance status is stated in the material.

  • Expectations: A description of the comprehensive patient information the practice needs from the patient and patient’s previous and other current providers to effectively serve as the patient’s medical home. This information includes current medications, allergies, visits to specialists, medical history, health status, behavioral health care, recent test results, self-care information and data (or where to obtain it) from recent hospitalizations, specialty care or emergency department visits.

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