AMA 2008 Interim Meeting

Delegates Adopt Joint Principles of Patient-Centered Medical Home

By Barbara Bein
11/12/2008

The AAFP and other primary care specialty groups recently scored a huge win when the AMA House of Delegates threw its support behind the patient-centered medical home, or PCMH.

Photo of AAFP President Ted Epperly, M.D., speaking at 2008 AMA interim meeting

On-screen at the AMA interim meeting in Orlando, AAFP President Ted Epperly, M.D., testifies in a reference committee hearing about the benefits of the patient-centered medical home.

During the 2008 interim meeting of the AMA House of Delegates in Orlando, Fla., AMA delegates adopted, intact, the "Joint Principles of the Patient-Centered Medical Home" (3-page PDF; About PDFs), a document that was developed by the AAFP, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association.

The seven joint principles describe characteristics of the PCMH, including:

coordination of care to enhance the patient-physician relationship,
a focus on quality and safety,
enhanced access to care, and
a payment structure that recognizes the value of and pays physicians appropriately for coordinated services and care management.

AAFP President Ted Epperly, M.D., of Boise, Idaho, told AAFP News Now that the adoption of the principles is "historic" for the Academy because it "brings on board the AMA's support of the Joint Principles of the PCMH as a health care delivery system that's rooted deeply in primary care for the people of America."

Epperly, testifying in support of the PCMH during a reference committee hearing on Nov. 9, said that the principles exemplify "comprehensive patient-centered health care with deep trusting relationships with a patient's personal physician and his or her practice in which care is integrated, coordinated and focused on the whole person."

"Multiple state, national and international studies have demonstrated that this care will increase the value of health care by increasing quality and lowering cost," Epperly testified.

For that reason, Epperly noted, the joint principles are "foundational" to the work of the Patient-Centered Primary Care Collaborative, or PCPCC, a coalition of more than 300 organizations -- including numerous Fortune 500 companies, the nation's biggest insurers, the AARP, consumer organizations and unions -- and the National Business Group on Health.

Dale Moquist, M.D., of Houston, chair of the Academy's delegation to the AMA, told AAFP News Now that the delegates' action indicates "where the house of medicine is going to be" on this issue. "When we're testifying about health system reform and the benefits of the PCMH, the AMA can be right beside us," he said.

In all, the delegates acted on several resolutions related to the medical home introduced by the California delegation and by the AMA Medical Student Section in conjunction with the Wisconsin delegation.

One amendment the delegates added was referred to the Board of Trustees for further study. That amendment calls on the AMA, working with all interested specialty societies, to continue to study the patient-centered medical home concept, with particular emphasis on ensuring that:

the value-added services of the medical home are fully funded by financing mechanisms outside the Medicare Part B physician payment pool, including from private insurance, Medicare Parts A and D, and Medicaid;
patient access to necessary quality specialty care without a gatekeeper is preserved;
patients can select any qualified physician practice as their medical home; and
the house of medicine is unified on this issue.

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