Joint Commission Develops Primary Care Home Option

The Joint Commission, a Chicago-based accreditation organization, announced recently that it is developing standards for a primary care home accreditation option that will complement the commission's existing Ambulatory Care Accreditation Program.

Lon Berkeley, the Joint Commission's project director for community health center accreditation, told AAFP News Now that the commission purposely chose the term "primary care home" to differentiate its initiative from similarly-worded initiatives, such as the National Committee for Quality Assurance's medical home recognition program and CMS' advanced primary care practice pilot projects.

"Our term -- primary care home -- says that this is an option available from the Joint Commission," said Berkeley, adding that participation is contingent upon an organization's ambulatory care accreditation.

A Joint Commission press release sets the target date for commencement of the new program as July 2011.

The Joint Commission, which was founded in 1951, established its ambulatory health care accreditation program in 1975. The commission offers accreditation to a variety of organizations, including group medical practices of all sizes.

Joint Commission accreditation is optional for most organizations, with the sole exception being ambulatory surgery centers that accept Medicare reimbursement.

Primary care home components as established by the Joint Commission mirror those of the AAFP-preferred patient-centered medical home model. For instance, the primary care home requires the provision of team care, increased patient access to care and coordination of the team care by a primary care professional, though not necessarily by a primary care physician. A primary care home also uses evidence-based treatment protocols and focuses on patient and family education and self-management.

Bruce Bagley, M.D., the AAFP's medical director of quality improvement, assessed the commission's primary care home initiative and provided comments to the organization via participation on a stakeholder feedback panel.

He emphasized that both the primary care home and the patient-centered medical home models of care have teamwork as their focus.

"The health care team working together is more effective and more efficient than any single health care professional could possibly be alone," said Bagley. "This new primary care home accreditation option will be a good thing to the degree that it promotes true team-based care."

As for the primary care home accreditation's application to family physicians, Bagley said, "There has to be a financial or market advantage for an organization to make that investment in Joint Commission accreditation." The health care home must also be "the antidote to the current fragmentation of health care, or it will not be successful for patients."

Berkeley said organizations do indeed look for the "value" in accreditation. He pointed out that accreditation fundamentally improves the quality and safety of patient care by ensuring that organizations initiate procedures for processes such as infection control, medication management, test documentation and clinical record documentation.

FPs most likely interested in the new Joint Commission offering would be those who work in large, primary care-dominated practices or FPs who care for patients in community health centers, or CHCs.

Berkeley added that HHS' Bureau of Primary Health Care is pushing for -- and funding -- Joint Commission accreditation of federally qualified CHCs.

"As a result, we have almost 300 CHCs that are accredited, and most of them (employ) some family physicians," said Berkeley. Accredited CHCs are among those organizations that can choose the Joint Commission's primary care home option when it becomes available next year.