Medical Home Recognition & Accreditation Programs

Several organizations have developed or in the process of developing programs that recognize and/or accredit various health care organizations as medical homes according to specified sets of standards.

In March 2011, four organizations representing more than 350,000 primary care physicians developed joint Guidelines for Patient-Centered Medical Home Recognition and Accreditation Programs . The guidelines—created by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), and the American Osteopathic Association (AOA)—build on the Joint Principles of the Patient-Centered Medical Home , which the four groups developed and adopted in February 2007. Please click here for the AAP Press Release about the joint guidelines.

Patient-Centered Medical Home (PCMH) Recognition Program
The National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) 2011 is a recognition program for improving primary care. In a set of standards that describe clear and specific criteria, the program gives practices information about organizing care around patients, working in teams and coordinating and tracking care over time. PCMH 2011 builds upon previous NCQA programs, specifically the Physician Practice Connections® (PPC®) recognition program developed in 2006 which recognized physician practices that use information systematically to enhance the quality of patient care. A new version of the NCQA PPC program launched in January 2008, entitled the Physician Practice Connections®-Patient-Centered Medical Home™ (PPC®-PCMH™) recognition program. This version of the program emphasized the systematic use of patient-centered, coordinated care management processes. NCQA launched PCMH 2011 in February 2011.

There have been several important changes to the content of the PCMH 2011 program, including the reduction of the number of standards from nine to six (access and continuity; identify and manage patient populations; plan and manage care; self-management support; track and coordinate care; and performance measurement and quality improvement) and a requirement for practices to measure the patient experience of care. The 2011 standards also align closely with Stage 1 Meaningful Use criteria. NCQA recently developed the Distinction in Patient Experience Reporting to help practices capture feedback through the new CAHPS PCMH Survey. NCQA PCMH-Recognized practices may use the CAHPS PCMH survey to obtain the distinction. Practices without recognition may still submit and CAHPS PCMH results, but may earn distinction only after achieving NCQA PCMH Recognition. Submitted data will be used to develop a benchmarking database that will allow comparison across practices.

NCQA Recognition Programs hold monthly customer education audio (telephone) conference workshops or WebEx training sessions. No reservations are required and there is no charge for these sessions. These sessions include introductory information on the process (Getting on Board with PCMH); a review of the PCMH standards and elements (PCMH 2011 Standards); the application process including the multi-site application (The Online Application and How to Submit as a Multi-Site) and the use of the Web-based data collection and submission tool (Using the Interactive Survey System [ISS] for PCMH 2011).

• Patient-Centered Medical Home Assessment Tool
  Primary Care Development Corporation
  Primary Care Development Corporation, a not-for-profit organization providing financing and services to expand access to care in underserved communities, has released an update of its free online Patient-Centered Medical Home Assessment Tool. This update reflects the new NCQA PCMH 2011 standards.

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Patient Centered Health Care Home Programs
URAC has developed its Patient Centered Health Care Home (PCHCH) Programs to educate and guide health care practices, and/or their sponsoring health plans, insurers, and pilot programs, on how to transform practices into patient-centered health care homes. URAC defines a Patient Centered Health Care Home (PCHCH) as a quality driven, interdisciplinary clinician-led team approach to delivering and coordinating care that puts patients, family members, and personal caregivers at the center of all decisions concerning the patient's health and wellness. A PCHCH provides comprehensive and individualized access to physical health, behavioral health, and supportive community and social services, ensuring patients receive the right care in the right setting at the right time.

URAC’s PCHCH program ranges from voluntary education and self-assessment to comprehensive on-site validation of the range of processes and management functions leading to a URAC PCHCH Achievement. URAC’s PCHCH Standards are developed to align with the dimensions of the Institute of Medicine’s (IOM) Six Aims of Quality Health Care. The URAC PCHCH Program includes five products:

• URAC PCHCH Practice Achievement (includes seven modules and two levels of recognition)
• URAC PCHCH Auditor Certification
• URAC PCHCH Program Toolkit (PCHCH Practice Standards) and Information Resources
• URAC PCHCH Primer
• URAC PCHCH Educational Webinars

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Primary Care Medical Home Option
Recognizing the benefits of increased access to health care, continuity of care, and patient-centered care, The Joint Commission launched in July 2011 a Primary Care Medical Home (PCMH) Certification Option for its accredited Ambulatory Care customers. A similar certification option for primary care practices that are included within the scope of a hospital’s accreditation certificate is targeted to be available by January, 2013. These Certification Options enable the improvements in quality of care and patient safety achieved through accreditation to be combined with increased reimbursement when the additional expectations of a Primary Care Medical Home are met. Click here to request access to the application, and click here to view the requirements.

The current PCMH Certification Option complements the Ambulatory Care Accreditation Program, and includes an additional 52 PCMH-specific requirements covering 5 key operational characteristics. A Self-Assessment Tool is available so organizations can review these requirements and determine if they would like to apply to receive this optional certification. Distinguishing features of the Joint Commission’s PCMH Certification Option include:

• On-site survey process to evaluate compliance with both existing accreditation and new PCMH requirements
• No special application requirements
• Organization-wide certification for up to 3 years
• Primary Care Medical Home certification publicly available on Quality Check

For more information about which accredited organizations have received the PCMH certification, comparisons to other qualifying programs, a copy of the Self Assessment Tool, and other materials, visit the Joint Commission Web site.

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Medical Home Accreditation/Certification
The Accreditation Association for Ambulatory Health Care, also known as AAAHC or the Accreditation Association develops standards to advance and promote patient safety, quality and value for ambulatory health care through peer-based accreditation processes, education and research. Accreditation is awarded to organizations that are found to be in compliance with the Accreditation Association standards via a peer-based survey. An organization can be accredited as a medical home by achieving additional standards aligned with the tenets of a patient-centered medical home.

The AAAHC also offers offer on-site certification surveys for organizations seeking medical home accreditation. Accreditation consists of a survey of practice staff, the facility, equipment, medical procedures and coordination and Quality of care procedures. The AAAHC medical home surveys are unique in that they are peer-based; they are conducted by professionals who are experienced ambulatory health care providers. During the actual survey, AAAHC works with providers/practices collaboratively and consultatively to assure that patients receive high-quality care consistent with AAAHC standards for the ideal medical home model.

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Patient-Centered Medical Home Recognition Tools: A Comparison of Ten Surveys' Content and Operational Details
The Urban Institute
This report highlights key features of 10 provider survey tools (eg, NCQA PCMH 2011, AAAHC Medical Home Accreditation Standards, Joint Commission's Primary Care Home Designation Standards, etc) to facilitate the selection of tools by payers.

The Patient-Centered Medical Home Guidelines: A Tool to Compare National Programs 
Medical Group Management Association
This resource is a comparison chart of four medical home recognition programs (NCQA, AAAHC, Joint Commission, and URAC) to assess how each of them meet the Guidelines for Patient-Centered Medical Home Recognition and Accreditation Programs' . This comparison is aimed at helping organizations narrow their assessment of the various programs and focus on the most important elements.

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