Best Health Primary Care

Best Health Primary CareBest Health Primary CareBest Health Primary Care

(203) 375-6320

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    • Home
    • Menu
      • Telemedicine Visit
      • About: L. D'Onofrio DNP
      • Schedule Appointmet
      • Community
      • Patient Portal
      • Insurance Info & Bill Pay
      • PCMH

(203) 375-6320

Best Health Primary Care

Best Health Primary CareBest Health Primary CareBest Health Primary Care
  • Home
  • Menu
    • Telemedicine Visit
    • About: L. D'Onofrio DNP
    • Schedule Appointmet
    • Community
    • Patient Portal
    • Insurance Info & Bill Pay
    • PCMH

Patient-Centered Medical Home: Our Commitment

Doctor examining a young girl while her mother watches.

Patient-Centered Medical Home

 

Patient-Centered Medical Home

Our Commitment to Patient-Centered Care

Our practice is committed to providing accessible, coordinated, comprehensive, and patient-centered primary care. We believe that high-quality healthcare is built around an ongoing relationship between patients, their healthcare team, and the community resources available to support their health.

As part of our commitment to continuous improvement, our practice is pursuing Patient-Centered Medical Home (PCMH) Recognition through the National Committee for Quality Assurance (NCQA).

Our goal is to make your healthcare more accessible, coordinated, personalized, and focused on your individual health needs.

What Is a Patient-Centered Medical Home?

A Patient-Centered Medical Home is a model of primary care that emphasizes an ongoing relationship between patients and their primary care team.

Rather than treating each medical issue as an isolated visit, the medical home model focuses on your overall health and helps coordinate your care across different healthcare providers and services.

Our practice's approach includes:

  • Accessible primary care
  • Comprehensive preventive care
  • Chronic disease management
  • Care coordination
  • Communication between healthcare providers
  • Patient education and engagement
  • Medication management
  • Preventive health services
  • Follow-up after hospitalizations and other significant healthcare events
  • Continuous quality improvement

Patient-Centered Access

We strive to make it as convenient as possible for our patients to receive the care they need.


Scheduling Appointments

Patients may contact our office to schedule appointments, discuss medical concerns, request follow-up care, or determine what type of appointment may be appropriate.

When appropriate, our team will help determine whether a concern requires an office visit, a telehealth visit, urgent evaluation, or another level of care.


Urgent Medical Concerns

If you have an urgent medical concern during normal office hours, please contact our office so that our healthcare team can help determine the appropriate next step.

For medical emergencies, call 911 or go to the nearest emergency department.


After-Hours Care

When the office is closed, patients should follow the after-hours instructions provided by the practice.

For emergencies, call 911.


Your Healthcare Team

Our practice uses a team-based approach to primary care.

Your healthcare team may include your primary care practitioner, nurses, medical assistants, administrative staff, care coordinators, and other healthcare professionals working together to support your care.

Our team works together to help:

  • Address your immediate healthcare concerns
  • Monitor chronic medical conditions
  • Coordinate referrals
  • Review medications
  • Provide preventive care
  • Follow up on important test results
  • Support healthy lifestyle changes
  • Help you understand your treatment options

Our goal is for patients to know who to contact and how to access the appropriate member of their healthcare team.


Knowing and Managing Our Patients

We believe effective primary care begins with understanding the individual patient.

During your visits, we consider your medical history, medications, preventive-care needs, chronic conditions, health goals, and other factors that may affect your health.

Our practice works to identify appropriate preventive and chronic-care services, including when applicable:

  • Annual and preventive examinations
  • Immunizations
  • Cancer screening
  • Cardiovascular risk assessment
  • Diabetes screening and management
  • Blood pressure management
  • Cholesterol management
  • Weight and lifestyle counseling
  • Medication review
  • Age-appropriate preventive services

Patients are encouraged to participate actively in decisions regarding their healthcare.


Chronic Disease Management

Our practice provides ongoing management and monitoring of chronic medical conditions.

Depending on your individual healthcare needs, this may include conditions such as:

  • Diabetes
  • Hypertension
  • Hyperlipidemia
  • Cardiovascular disease
  • Asthma
  • COPD
  • Thyroid disorders
  • Obesity
  • Other chronic medical conditions

Chronic disease management may include monitoring laboratory results, reviewing medications, establishing treatment goals, providing education, coordinating specialty care, and scheduling appropriate follow-up.

Our objective is to work with patients to develop an individualized plan of care.


Care Management

Some patients require additional support to successfully manage their healthcare.

When appropriate, our practice may provide additional care-management services for patients who have complex medical needs, multiple chronic conditions, medication concerns, or other factors requiring increased coordination.

Care management may include:

  • Reviewing treatment plans
  • Medication reconciliation
  • Monitoring chronic conditions
  • Coordinating appointments
  • Supporting treatment adherence
  • Patient education
  • Communication with specialists
  • Follow-up after significant medical events
  • Connecting patients with appropriate community or healthcare resources


Care Coordination

Healthcare often involves multiple providers and healthcare organizations.

Our practice works to coordinate care when patients receive services from specialists, hospitals, urgent-care facilities, imaging centers, laboratories, and other healthcare organizations.

When appropriate, care coordination may include:

  • Referral coordination
  • Sharing relevant medical information
  • Reviewing specialist recommendations
  • Following up on outstanding tests or referrals
  • Medication reconciliation
  • Reviewing hospital or emergency-department records
  • Helping patients understand their next steps
  • Communicating with other members of the healthcare team

Patients should inform our office about healthcare services received outside of our practice so that relevant information can be incorporated into their medical record when available.


Transitions of Care

Transitions between healthcare settings are important times when communication and coordination can help prevent gaps in care.

When appropriate, our practice works to follow up with patients after:

  • Hospitalization
  • Emergency-department visits
  • Significant urgent-care visits
  • Procedures
  • Other major healthcare transitions

Follow-up may include reviewing discharge instructions, medications, testing, referrals, and the patient's ongoing treatment plan.


Medication Management

Medication safety is an important part of primary care.

Our healthcare team reviews medications as appropriate and encourages patients to keep an accurate list of all prescription medications, over-the-counter medications, vitamins, and supplements they are taking.

Patients should notify our office about:

  • New medications prescribed by other providers
  • Medication changes
  • Medication allergies or adverse reactions
  • Difficulty obtaining medications
  • Medication side effects
  • Questions regarding how medications should be taken

Medication reconciliation may be performed during appropriate visits and care transitions.


Patient Education and Engagement

We believe patients should be active participants in their healthcare.

Our healthcare team works with patients to understand:

  • Their medical conditions
  • Treatment options
  • Medications
  • Preventive-care recommendations
  • Laboratory and diagnostic results
  • Lifestyle recommendations
  • When additional medical evaluation may be necessary

We encourage patients to ask questions and participate in shared decision-making regarding their healthcare.


Patient Communication

Clear communication between patients and their healthcare team is an important part of our practice.

Patients may contact the practice regarding appropriate medical questions, appointments, medications, referrals, test results, and other healthcare needs using the communication methods made available by our office.

Please allow appropriate time for routine messages and requests to be reviewed by the healthcare team.

If you are experiencing a medical emergency, do not use electronic messaging or wait for a response from the office. Call 911 or seek emergency medical care.


Patient Portal

If our practice provides access to a secure patient portal, patients are encouraged to use the portal for appropriate communication and access to available health information.

The patient portal may be used, when available, for services such as:

  • Viewing portions of your health information
  • Communicating with the healthcare team
  • Requesting appointments
  • Requesting medication refills
  • Reviewing available laboratory results
  • Receiving healthcare information

Portal availability and functionality may vary depending on the service being used.


Preventive Care

Prevention is a fundamental component of primary care.

Our practice works with patients to identify preventive services appropriate for their age, medical history, risk factors, and individual circumstances.

Preventive care may include:

  • Immunizations
  • Cancer screening
  • Cardiovascular risk assessment
  • Diabetes screening
  • Blood pressure screening
  • Cholesterol screening
  • Preventive examinations
  • Lifestyle counseling
  • Tobacco-use screening and cessation support
  • Other age- and risk-appropriate preventive services

We encourage patients to discuss recommended preventive services with their healthcare provider.


Tobacco Cessation and Health Promotion

Our practice supports patients who wish to reduce or stop tobacco and nicotine use.

Depending on the patient's needs, tobacco-cessation support may include:

  • Assessment of tobacco use
  • Counseling
  • Behavioral support
  • Discussion of evidence-based cessation options
  • Medication discussions when appropriate
  • Follow-up to monitor progress

Our healthcare team can work with patients to develop an individualized plan.


Behavioral and Social Needs

Health is influenced by more than medical conditions alone.

When appropriate, our practice may discuss factors that can affect a patient's ability to maintain good health, including access to healthcare, medications, transportation, nutrition, physical activity, tobacco use, and other social or behavioral factors.

When appropriate resources are available, our team may help patients identify community or healthcare resources that can provide additional assistance.


Quality Improvement

Our practice is committed to continuously evaluating and improving the care we provide.

Quality improvement may include reviewing practice processes, preventive-care measures, chronic disease management, patient access, care coordination, and other aspects of healthcare delivery.

We use appropriate information and data to identify opportunities for improvement and implement changes designed to improve patient care and the patient experience.


Your Role in Your Healthcare

A successful Patient-Centered Medical Home is a partnership between the patient and healthcare team.

You can help us provide better care by:

  • Keeping your appointments
  • Bringing an updated medication list to appointments
  • Informing us about changes in your health
  • Informing us about care received from other healthcare providers
  • Completing recommended laboratory testing and screenings
  • Asking questions when you do not understand something
  • Following your individualized treatment plan
  • Using available patient communication tools appropriately
  • Letting us know when you have difficulty following your treatment plan

Your questions, concerns, and feedback are important to us.


Feedback From Our Patients

We value feedback from our patients and use it to help identify opportunities to improve our practice.

If you have a concern, suggestion, or experience that you would like to share, please contact our office.

Patient feedback may be used as part of our ongoing commitment to improving access, communication, coordination, and the overall patient experience.


Our Commitment to Continuous Improvement

Our practice is committed to continuously improving the quality, safety, accessibility, and coordination of the healthcare we provide.

Our Patient-Centered Medical Home approach is intended to ensure that patients have a healthcare team that knows them, understands their healthcare needs, coordinates their care, and works with them to achieve their individual health goals.

We appreciate the opportunity to serve our patients and remain committed to providing high-quality, compassionate, and patient-centered primary care.


Important Medical Information

This website is intended to provide general information about our practice and our approach to patient care. It is not intended to replace individualized medical advice from your healthcare provider.

For medical emergencies, call 911 or go to the nearest emergency department.

For routine medical questions or concerns, please contact our office using the appropriate communication method provided by the practice.


Patient-Centered Medical Home

Our Practice
Committed to accessible, coordinated, comprehensive, and patient-centered primary care.


NCQA Patient-Centered Medical Home Recognition:
Recognition status should be listed here once officially awarded by NCQA.

Last Updated: September 2026


Copyright © 2026 Best Health Primary Care - All Rights Reserved.


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