Patient Aligned Care Teams (PACT): VA’s Journey to Implement Patient-Centered Medical Homes

Excerpt

In 2010, the US Department of Veterans Affairs (VA) launched national implementation of patient-centered medical homes (PCMH) through the Patient Aligned Care Teams (PACT) initiative, as described by Gordon Schectman and Richard Stark, the chief architects of PACT, in their commentary to this Supplement. Concurrently, the PACT initiative aimed to incorporate rigorous formative and summative evaluation of PACT implementation and to promote PACT-related innovation development and testing. To accomplish these goals, the initiative established a national evaluation team (based in Seattle) and competitively funded five PACT Demonstration Laboratories (in Ann Arbor, Los Angeles, Iowa City, Philadelphia, and Portland). In addition, embedded health services researchers and clinical leader partners from outside the Demonstration Laboratories undertook relevant studies. Together, the implementation and evaluation components of PACT as reported in this Supplement’s articles document opportunities and challenges in implementing a PCMH in integrated healthcare systems that are both specifically relevant to VA and informative to other managed care or Accountable Care Organizations (ACOs) engaged in implementing PCMH models. In addition, as highlighted in the Reid and Wagner commentary in this Supplement, the articles have implementation science implications as they delve into components of the Chronic Illness Care Model. …