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Updated: May 6, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Helping primary care practices attain patient-centered medical home (PCMH) recognition through collaboration with a
Sandi J Lane1, R W Chip Watkins
1the College of Health Sciences, Appalachian State University, Boone, NC; and Community Care of North Carolina, Raleigh, NC.
Purpose:
Transforming a primary care practice into a patient-centered medical home (PCMH) is a resource-dependent endeavor. The objective of our study was to evaluate a facilitation model used to support rural primary care practices during a redesign of their processes to achieve recognition as National Center for Quality Assurance PCMHs.
Methods:
The model was a collaboration between Community Care of North Carolina and a local university where undergraduate students worked directly with practices under the guidance of a Community Care of North Carolina PCMH Team.
Results:
The facilitation model resulted in positive outcomes for both primary care practices and students.
Conclusions:
Partnerships between care networks, agencies, payers, or practices and universities or colleges can yield mutual benefits and should be explored.
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