WASHINGTON – Thirteen new guidelines for the patient-centered medical home recognition and accreditation program were released Tuesday by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association.

Officials from the four organizations, which represent more than 350,000 primary care physicians, said the new guidelines build on the Joint Principles of the Patient-Centered Medical Home, which they developed and adopted in February 2007, but aim at further ensuring standardization among accreditation programs.

"If we are to know the value of a patient-centered medical home's accreditation, we need to be assured the accrediting program itself has met appropriate standards," said Roland Goertz, MD, MBA, FAAFP president of the AAFP. "These guidelines help define those standards for accreditation programs."
 
Currently three nonprofit groups – the National Committee for Quality Assurance, the Accreditation Association for Ambulatory Health Care, and URAC (formerly known as the Utilization Review Accreditation Commission) – have established recognition, accreditation, or other relevant programs. One other nonprofit organization, the Joint Commission, plans to have a program in place by the middle of this year.

[See also: New patient-centered medical home standards align with MU.]
 
The AAFP, AAP, ACP and AOA developed the guidelines to describe elements considered essential for effective PCMH recognition programs. The guidelines say that programs should attempt to assess all of the primary care domains outlined by the Institute of Medicine – comprehensiveness, coordination, continuity, accessibility and patient engagement and experience.

"The consideration of these joint guidelines for PCMH recognition progams will help ensure that recognized practices truly provide patient-centered care that is effectively integrated and of high quality," said ACP President J. Fred Ralston Jr., MD, FACP.

[See also: NCQA recognizes 51 sites with top patient-centered medical home status]

According to the guidelines, all PCMH recognition or accreditation programs should:

1. Incorporate the Joint Principles of the PCMH
2. Address the complete scope of primary care services
3. Ensure the incorporation of patient and family-centered care emphasizing engagement of patients their families, and their caregivers
4. Engage multiple stakeholders in the development and implementation of the program
5. Align standards, elements, characteristics, and/or measures with meaningful use requirements
6. Identify essential standards, elements, and characteristics
7. Address the core concept of continuous improvement that is central to the PCMH model
8. Allow for innovative ideas
9. Acknowledge care coordination within the medical neighborhood
10. Clearly identify PCMH recognition or accreditation requirements for training programs
11. Ensure transparency in program structure and scoring
12. Apply reasonable documentation/data collection requirements
13. Conduct evaluations of the program's effectiveness and implement improvements over time

"Adoption of these principles will ensure that PCMH recognition programs meet a minimal set of standards, thus providing physicians reassurance that their practice recognition program is consistent with others in the marketplace," said Karen J. Nichols, DO, president of the American Osteopathic Association.
 
The AAFP, AAP, ACP and AOA sent the joint guidelines to NCQA, AAAHC, The Joint Commission and URAC to encourage their use in the development, implementation  and evolution of their PCMH programs.

"The AAP urges adoption and support of these guidelines by governments, payers, providers and all others who are involved in the health, well-being and success of America's children and their families," said O. Marion Burton, MD, FAAP, president of the AAP.

 Click here to read the full guidelines.