Noting that “imitation is the sincerest form of flattery,” the four organizations that formed the original standards for what constitutes the patient-centered medical-home model of healthcare delivery are seeking to bring some consistency among the proliferation of organizations developing or accrediting the concept.
Docs offer guidelines for medical home accreditation
“Guidelines for Patient-Centered Medical Home Recognition and Accreditation Programs” is a list of 13 recommendations jointly developed by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association—the same groups that originally released a set of joint principles for medical homes in February 2007.
This latest release follows the rollout of revised medical home recognition standards from the National Committee for Quality Assurance a little over a month ago (Feb. 7, p. 10). “Having worked so closely and effectively with these medical societies on our PCMH program for the past few years, I believe we are well aligned with their guidelines,” Patricia Barrett, the NCQA’s vice president, product development, said in an e-mailed statement.
The new recommendations also come in the middle of the Joint Commission’s field test of its “primary-care home” accreditation program. “It’s an appropriate role for these important stakeholders to say, ‘Here’s what’s important,’ ” said Michael Kulczycki, executive director of the Joint Commission’s ambulatory care accreditation program. “It certainly does provide guidance.”
Michael Sullivan, spokesman for CareFirst, a Blue Cross and Blue Shield affiliate in Maryland, D.C. and northern Virginia, which has developed a medical home program in which 2,200 primary-care physicians are participating, also welcomed the release of the guidelines.
“The more steps that PCPs and others take to adopt the patient-centered medical home approach, the better,” Sullivan said in an e-mail. “We need to do a better job at managing chronic illnesses, by working with teams of clinicians to improve patient care.”
The Accreditation Association for Ambulatory Health Care and URAC also have medical-home accreditation programs in place.
Dr. Roland Goertz, president of the AAFP, said the developers of the primary-care physician-led team-based concept never copyrighted their work because they wanted the idea to proliferate, “but we don’t want it to be diluted.”
“The four organizations really are the owners of the model,” Goertz said. “Consistency of the model for the public is the goal.”
The 13 guidelines stress the need for engagement of multiple stakeholders when creating an accreditation program, as well as the importance of transparency in structure and scoring.
“The elements that must continue are comprehensiveness and continuity of care,” Goertz said, because research shows that’s where the medical home concept of delivering coordinated care shows improvements in outcomes and efficiency.
—with Maureen McKinney
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