Defining the Patient Centered Medical Home
Most people who work in health care and public health have heard the term "Patient Centered Medical Home," but it isn't always clear what the term means. The Patient Centered Medical Home (PCMH) is a model that has garnered national attention in the last several years, in large part because of the passage of the Affordable Care Act (ACA). The ACA emphasizes prevention, cost savings, and quality of care, all of which are important components of the PCMH model.
In a PCMH, care is highly coordinated and efficient, often due to the skilled use of electronic health records. Access to care is enhanced in various ways in a PCMH--whether through the use of extended hours, telephone or email access to doctors, group visits, or a combination of multiple strategies. Quality of care is emphasized in a PCMH by using a Continuous Quality Improvement framework for monitoring data and improving patient care. Perhaps most importantly, patients who receive care at a patient centered medical home are empowered to manage their own health and well-being. Early evidence shows that the PCMH model is associated with lower costs and a higher quality of care.
Agency for Healthcare Research and Quality (AHRQ), defines a medical home as "a model of the organization of primary care that delivers the core functions of primary health care." According to AHRQ, the five core attributes of a medical home are:
1) Patient centered
2) Comprehensive care
3) Coordinated care
4) Superb access to care
5) A systems-based approach to quality and safety
These attributes loosely correspond to the six elements outlined in the National Commitee for Quality Assurance (NCQA) 2011 PCMH Standards:
1) Enhance access and continuity
2) Identify and manage patient populations
3) Plan and manage care
4) Provide self-care and community support
5) Track and coordinate care
6) Measure and improve performance
The NCQA uses these standards to award formal "recognition" as a Patient Centered Medical Home to clinics that submit documentation showing that they meet the standards. The Joint Commission and the Accreditation Association for Ambulatory Health Care also offer accreditation and certification for medical homes.
Becoming a Patient Centered Medical Home is a long journey for any health care organization, and the transformation process is much more than just achieving recognition or certification. The principles of a Patient Centered Medical Home need to become "coded into an organization's DNA" in order for the model to be fully realized. For a visual representation of how sites move toward realizing the PCMH model, check out our PCMH Implementation Continuum.
To learn more about the PCMH model and the HIV ACCESS PCMH Demonstration Project please contact Erin Gael Chambers. |