1. Fagnan, Lyle J. MD
  2. Dorr, David A. MD, MS
  3. Davis, Melinda PhD, MA
  4. McGinnis, Paul MPA
  5. Mahler, Jo MS
  6. King, Molly McCarthy BA
  7. Michaels, LeAnn BS


This study sought to understand the acceptability and feasibility of office-based nurse care management in medium to large rural primary care practices. A qualitative assessment of Care Management Plus (a focused medical home model for complex patients) implementation was conducted using semistructured interviews with 4 staff cohorts. Cohorts included clinician champions, clinician partners, practice administrators, and nurse care managers. Seven key implementation attributes were: a proven care coordination program; adequate staffing; practice buy-in; adequate time; measurement; practice facilitation; and functional information technology. Although staff was positive about the care coordination concept, model acceptability was varied and additional study is required to determine sustainability.