AAFP, Other Groups Approve Guidelines for Standardization of PCMH Recognition Programs

As the patient-centered medical home, or PCMH, model of health care gains prominence in the United States, a number of entities are developing or offering medical home recognition or accreditation programs. This has led the AAFP, along with the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association, to create guidelines for PCMH recognition/accreditation programs to ensure that they are somewhat standardized.

Guidelines for Patient-Centered Medical Home Recognition and Accreditation Programs (6-page PDF; About PDFs) builds on the Joint Principles of the Patient-Centered Medical Home (3-page PDF; About PDFs), which also were developed by the four groups and adopted in February 2007. A second, related document, the Joint Principles for the Medical Education of Physicians as Preparation for Practice in the PCMH (12-page PDF; About PDFs), was adopted by the groups in December 2010.

According to Bruce Bagley, M.D., AAFP medical director of quality improvement, two nonprofit groups -- the National Committee for Quality Assurance and the Accreditation Association for Ambulatory Health Care (3-page PDF; About PDFs) -- already have established recognition or accreditation programs. Two other nonprofit organizations -- The Joint Commission and URAC (formerly known as the Utilization Review Accreditation Commission) -- are expected to have programs in place by the middle of this year.

"With four organizations accrediting or recognizing medical homes, we decided to develop guidelines to evaluate these programs. We want people to pay attention to what is important for patients," said Bagley.

The original PCMH joint principles comprise seven foundational components:

The new guidelines say that all PCMH recognition or accreditation programs should incorporate the joint principles of the PCMH. Specifically, such programs should

According to Bagley, the most important PCMH joint principles concerning program accreditation and recognition are those that address the comprehensiveness of care and the team approach to medical practice.

"The medical home can't be a referral hub that just sends patients to a (sub)specialist," said Bagley. "The comprehensive, personalized nature of care and the team approach are the essential things."

Bagley also noted that these recognition and accreditation systems are oriented to processes and are not designed to address the efficiency and economic benefits of the medical home in the health care system.

"It is important to realize that none of these recognition programs gives a complete and fair assessment of the value of primary care to patient outcomes or to the system in terms of cost savings," he said.