By now we are familiar with the shift taking place from a traditional volume-based; fee-for-service to a value-based, quality-driven healthcare payment model. The goal is to migrate from a high-cost service environment with no physician incentive alignment to a sustainable healthcare delivery system designed to improve care and hopefully control costs.

Policymakers across the political spectrum are investing in primary care and the primary care workforce with multiple initiatives, ranging from CMS multi-payer advanced primary care initiative to comprehensive primary care initiatives in the Affordable Care Act.

The Patient Centered Medical Home (PCMH) involves a three-tiered approach: higher quality healthcare, a better patient experience, and lower healthcare costs.

The History

The concept of PCMH began in 1967 when the American Academy of Pediatrics introduced a model to improve the care of children with complex care needs.

PCMH has evolved to become a widely accepted model among clinicians, health plans, employers, and many consumer groups. The PCMH model describes an evidence-supported set of expectations regarding how primary care should be organized and delivered for patients and their families.

The Agency for Healthcare Research and Quality identifies five core attributes of a medical home:

  1. Person centered— A well-established partnership among patients, their families, and their practitioners ensures healthcare decisions respect a patient’s needs and preferences. Patients have the education and support they need to make decisions and be an active participant in their own care.
  2. Comprehensive A team-based care approach that helps ensure care providers are accountable for a patient’s physical and behavioral health care needs. A focus on acute and chronic care and prevention and wellness are central to the team’s responsibilities.
  3. Accessible — Patients are able to access healthcare services with shorter waiting times, “after hours” care, 24/7 electronic or telephone access. They can communicate with providers through secure email, patient portals, or other health IT tools.
  4. Coordinated — Many healthcare elements are coordinated across the system including;    specialty care, hospitals, home health care, and community services.
  5. Committed to quality and safety through a systems approach — Improved care quality through the use of health IT and other tools to ensure patients and families make informed decisions about their health.

The first thing you need to do if you’re on the path to PCMH is choose a recognition program. From there, follow the standards outlined to become recognized. Have questions? Learn more about how you can gain recognition.